Case in Point: Using Cognitive Behavioral Therapy for PTSD

Asian Americans are the fastest growing ethnic group in New York City, and they often face unique and difficult challenges, including an unfamiliar language and culture; poverty; and conflict between immigrant parents and American-raised children. The Child Center of NY’s Asian Outreach Program helps families handle these challenges by providing mental health screening, information, and counseling to low-income Asian American youth and their families. AOP’s bilingual and bicultural therapists are steeped in the culture of their clients — enabling them to reach troubled young people before they slip through the cracks.

Meiling is a 17-year-old AOP client who began therapy at our Flushing Clinic after nearly losing her life during what should have been a simple surgery. The flashbacks, excessive worries, and other PTSD symptoms — on top of the stresses of being a recent immigrant — became too much for Meiling, and she was admitted to Elmhurst Hospital Center, which then referred her to our Flushing Clinic for therapy.

“Meiling felt a lot of fear about going back to school and walking in crowds,” explains her current therapist, Yezi Qiu. “She experienced depressed mood and worries that impacted her home, school, and social functioning. She didn’t feel comfortable sharing her worries with family or friends — and withdrew from both. She became anxious about how other students and teachers would judge her, to the point that she didn’t attend school for quite a long time.”

Qiu and Meiling’s previous therapist, Cathy Wu, provided Meiling the space for her to verbalize her fears and develop coping skills using cognitive behavioral therapy, a form of psychotherapy that focuses on identifying and changing destructive patterns of behavior. Using this method, they helped Meiling identify unhelpful thinking patterns (for example, her tendency to jump to conclusions, disqualify the positive, and overgeneralize) and practiced challenging them. Meiling also identified and utilized her support system — which she discovered included her family. “Cathy helped my father and cousin understand what depression is. Having family’s understanding and support gave me more motivation to change,” says Meiling. Exploring her hobbies and dreams and reengaging in school and social life was also part of therapy, and Meiling began learning to play guitar, taking an SAT prep course, and spending time with friends.

“It’s very hard for people with depression to go back to daily activities,” Qiu says. “Meiling challenged herself and made it happen. She even chose to work a parttime summer job at her uncle’s restaurant, which required her to interact with all kinds of people. By summer’s end, she reported having significantly improved mood.”

Of course, the road to recovery wasn’t entirely without roadblocks, and Meiling had a relapse in September, triggered by her annual health check-up, after which she withdrew from school for a week and had suicidal thoughts; but she was willing to continue talking with Qiu in therapy. “She talked about her fears and learned more facts about PTSD. We also actively involved her family more,” says Qiu. With support from family, friends, and therapist, Meiling practiced processing and coping with her feelings, and she has been attending school regularly ever since.

“It was a very dark period; I felt hopeless,” Meiling says of her time before therapy. “But Cathy listened and provided a lot of support. She helped me identify my problems and taught me how to break down my goals into baby steps. I survived from my depressed mood because of her help, and then with Yezi, I became more independent and found my true self.