Paper for Issue

Addressing recurrent war trauma and post-traumatic stress disorders in a veteran through combined therapeutic modalities

Abstract

This case study presents a war veteran grappling with enduring psychological trauma decades after active combat participation in Zimbabwe and a neighbouring country. The client, having witnessed the loss of comrades and experienced intense terror on the battlefield, was plagued by vivid, intrusive memories of combat scenes dominated by gunfire and bloodshed. Clinical interviews and Mental Status Examination revealed debilitating panic attacks, specifically triggered by war-related memories. Standardized assessment tools including the Davidson Trauma Scale and the DSM-5 Posttraumatic Stress Disorder Checklist (PCL-5) concluded a diagnosis of Post-Traumatic Stress Disorder (PTSD). Therapeutic interventions implemented comprised narrative therapy, Jung’s Self-Shadow technique, and cognitive behavioural therapy, aimed at processing traumatic memories, integrating shadow aspects of the self, and restructuring maladaptive cognitions. These modalities collectively contributed to a significant reduction in PTSD symptoms and panic attacks, alongside improved emotional regulation and daily functioning by the conclusion of therapy. This outcome highlights the efficacy of a multimodal therapeutic approach in alleviating chronic combat-related trauma and enhancing psychological resilience. Such evidence supports ongoing efforts to refine interventions addressing enduring trauma in veteran populations within psychological practice and research contexts.

Forensic Psychological Evaluation of an Incarcerated Client with Schizophrenia: A Case Report on Psychosis-Driven Arson

Abstract

The psychiatric evaluation of N, a 33-year-old Zimbabwean man detained at Chikurubi Maximum Prison Psychiatric Hospital after being charged with arson and attempted homicide during a psychotic episode, is presented in this forensic case report. N was diagnosed with schizophrenia (DSM-5-TR F20.0) following a thorough evaluation that included psychometric testing, a mental status assessment, collateral interviews, and risk assessment. The results showed auditory hallucinations, persistent persecutory delusions, diminished insight, and a high risk of violence or harm to others if left unattended. The client's history, clinical presentation, evaluation findings, and formulation are all covered in depth in the report, which ends with suggestions for ongoing inpatient mental health treatment, organised supervision, and medication compliance. The case emphasises how crucial forensic psychological evaluations are to striking a balance between public safety concerns and professional treatment.

Understanding Pica and Delayed Developmental Milestones in Children with Intellectual Disability: A Psycho-educational Case Study

Abstract

This psycho-educational case study investigating the relationship between Pica, a feeding and eating disorder characterized by the persistent ingestion of non-nutritive substances, and significant developmental delays in a child with Intellectual Disability (ID) and co-occurring Neurodevelopmental disorders. The study assessed the behavioural, cognitive, and adaptive profile of Tinashe, a 14-year-and-4-month-old male who had never attended formal schooling and presented with profound developmental delays, non-verbal communication, and chronic Pica behaviours. A mixed-methods approach was utilized, incorporating caregiver interviews, direct behavioural observations, a Mental Status Examination, and the Vineland Social Maturity Scale (VSMS) to assess adaptive functioning. Findings indicated that Tinashe exhibited profound delays in speech,motor coordination, and social interaction, consistent with moderate ID and mild Autism Spectrum Disorder (ASD) traits. His Pica behaviour, which included the ingestion of sand and stones, posed serious health risks and was compounded by poor impulse control and lack of safety awareness. Adaptive functioning was significantly below age expectations, reflected by a Social Coefficient (SQ) of 35, and a failure to establish toilet training. The case concluded that the persistence of Pica and severe developmental delays necessitates urgent multidisciplinary support, including medical evaluation, Applied Behaviour Analysis (ABA) based therapy, and specialized educational placement with an Individualised Educational Plan (IEP), contingent upon successful toilet training. Recommendations focus on structured routines, positive reinforcement, environmental safety, and comprehensive caregiver training.

Exploring Separation Anxiety in Childhood: A Case Report of an 8-Year-Old Zimbabwean Girl after Cross-Border Relocation

Abstract

This case study examines the therapeutic journey of Zuva, an 8-year-old Zimbabwean girl presenting with moderate separation anxiety following her family’s relocation from Botswana to Zimbabwe. Initial assessments included clinical interviews and two standardized anxiety measures, Screen for Child Anxiety Related Emotional Disorders (SCARED) and Separation Anxiety Scale for Children (SASC), with Zuva’s scores indicating clinically significant anxiety. Behavioral indicators included persistent crying at school drop-off, refusal to sleep alone, and recurrent somatic complaints (e.g., stomach aches) when separated from her mother. The psychologist diagnosed Separation Anxiety Disorder (DSM-5-TR F93.0) and implemented a multimodal intervention comprising play therapy, cognitive-behavioural therapy (CBT), and structured family involvement. Therapy spanned seven sessions of approximately one hour each. Post-intervention assessment revealed a reduction in SASC and SCARED scores alongside observable behavioural improvements such as independent sleeping, reduced school refusal, and increased social engagement with peers. Cultural differences between the two countries intensified Zuva’s distress, as her Shona-rooted expectations of maternal proximity clashed with the more collective caregiving practices encountered in Botswana. Cultural considerations informed therapeutic choices such as play therapy which was adapted to incorporate familiar Shona storytelling and symbols of kinship, while family sessions emphasized bridging Tswana communal expectations with Shona attachment practices. This culturally sensitive approach facilitated both emotional adjustment and strengthened family cohesion. Overall, the case underscores the importance of integrating standardized assessment, behavioural observation, and cultural context in tailoring interventions for childhood anxiety disorders, particularly in cross-border relocation scenarios.

Navigating adjustment challenges: A Case Study of migration-related stress in Zimbabwe

Abstract

This article presents the therapeutic journey of Tee, a 34-year-old woman from Zimbabwe experiencing adjustment difficulties following her husband’s relocation to the United Kingdom. To assess the client, the therapist used the Clinical Interview, Beck Depression Inventory- II (BDI-II), Generalized Anxiety Disorder (GAD-7), Parental Stress Scale (PSS) and Adjustment Disorder New Module (ADNM-20). The scores revealed mild depressive symptoms, moderate, high parental stress and risk of adjustment disorder respectively. A multimodal therapeutic approach integrating Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) was used to address her emotional distress, parenting challenges and reduced social engagement. Over the course of therapy, the client demonstrated improved coping strategies, reduced parental stress, and enhanced emotional resilience and re engagement in social support systems. The case highlights the importance of integrating culturally relevant and evidence-based interventions in supporting the clients facing migration related stressors.