A new CBT approach to CBT with PTSD due to childhood abuse

Cloitre, M., Koenen, K. C., Cohen, L. R. & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Clinical and Consulting Psychology, 70,1067-1074. ABSTRACT - Fifty-eight women with posttraumatic stress disorder (PTSD) related to childhood abuse were randomly assigned to a 2-phase cognitive-behavioral treatment or a minimum attention wait list. Phase 1 of treatment included 8 weekly sessions of skills training in affect and interpersonal regulation; Phase 2 included 8 sessions of modified prolonged exposure. Compared with those on wait list, participants in active treatment showed significant improvement in affect regulation problems, interpersonal skill deficits, and PTSD symptoms. Gains were maintained at 3- and 9-month follow-up. Phase 1 therapeutic alliance and negative mood regulation skills predicted Phase 2 exposure success in reducing PTSD, suggesting the value of establishing a strong therapeutic relationship and emotional regulation skills before exposure work among chronic PTSD populations.

Note: I think this is a very promising study. It specifically excluded subjects with borderline personality disorder but I wonder how the "Skills Training in Affective and Interpersonal Regulation" (STAIR) protocol would work with borderlines. It is based in part on Linehan's work and targets skills that many individuals with BPD need.

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