Cognitive-behavioral approaches to PTSD

• Report from AABT by Jim Pretzer, 11/30/96
  • Treatment of Post-Traumatic Stress Disorder (Highlights from a Poster Session) by Jim Pretzer, 11/30/96
    • How to treat PTSD by J. Kimbrough, M.A., 4/19/97
      
      

For cognitive-behavioral treatment of PTSD, I recommend Don Meichenbaum1s 1994 book 3Clinical Handbook/Practical Therapist Manual for Assessing and treating Adults with PTSD2, Institute Press,292 Shakespeare Drive, Waterloo, Ontario, Canada N2L 2V1.

A Medlines search also turns up the following:

1) Title: Treatment of posttraumatic stress disorder: a review.

Author: Shalev AY; Bonne O; Eth S

Address: Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel.

Source: Psychosom Med, 1996 Mar-Apr, 58:2, 165-82

Abstract: This article analyzes the literature on the treatment of posttraumatic stress disorder (PTSD). It briefly exposes the theoretical basis for each treatment modality and extensively examines pharmacological, behavioral, cognitive, and psychodynamic therapies, as well as group and family therapies, hypnosis, inpatient treatment, and rehabilitation. Articles were identified by scanning Medline and PsychLit for all papers in English reporting treatment of PTSD. Anecdotal case reports were, then, excluded. Eighty one articles were identified and categorized as either biological or psychological, with psychodynamic, and other treatment modalities. Information regarding the type of trauma, the sample studied, the treatment method, and the results of the treatment has been extracted from each article and is presented briefly. A synthesis of findings in each area is provided. Most studies explored a single treatment modality (e.g., pharmacological, behavioral). The cumulated evidence from these studies suggests that several treatment protocols reduce PTSD symptoms and improve the patient's quality of life. The magnitude of the results, however, is often limited, and remission is rarely achieved. Given the shortcoming of unidimensional treatment of PTSD, it is suggested that combining biological, psychological, and psychosocial treatment may yield better results. It is further argued that rehabilitative goals should replace curative techniques in those patients with chronic PTSD. A framework for identifying targets for each treatment modality is presented.

2) Title: Group cognitive-behavioral therapy for women with PTSD and substance use disorder.

Author: Najavits LM; Weiss RD; Liese BS

Address: Harvard Medical School/McLean Hospital, Belmont, MA 02178, USA. LNajavits@aol.com

Source: J Subst Abuse Treat, 1996 Jan-Feb, 13:1, 13-22

Abstract: This paper describes a model of group cognitive-behavioral therapy (CBT) for women with posttraumatic stress disorder (PTSD) and substance use disorder (SUD). The need for specialized treatment derives from the high incidence of these comorbid disorders among women as well as from their particular clinical presentation and treatment needs. The treatment educates patients about the two disorders, promotes self-control skills to manage overwhelming affects, teaches functional behaviors that may have deteriorated as a result of the disorders, and provides relapse prevention training. The program draws on educational principles to make it accessible for this population: visual aids, education for the patient role, teaching for generalization, emphasis on structured treatment, testing of acquired knowledge of CBT, affectively engaging themes and materials, and memory enhancement devices.

3) Title: Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims.

Author: Foa EB; Hearst-Ikeda D; Perry KJ

Source: J Consult Clin Psychol, 1995 Dec, 63:6, 948-55

Abstract: The efficacy of a brief prevention program (BP) aimed at arresting the development of chronic PTSD was examined with 10 recent female victims of sexual and nonsexual assault who received 4 sessions of a cognitive-behavioral program shortly after the assault. Their PTSD and depression severity was compared with that of 10 matched recent female assault victims who received repeated assessments of their trauma-related psychopathology (assessment control; AC). The BP program consisted of education about common reactions to assault and cognitive-behavioral procedures. Two months postassault, victims who received the BP program had significantly less severe PTSD symptoms than victims in the control condition; 10% of the former group met criteria for PTSD versus 70% of the latter group. Five and a half months postassault, victims in the BP group were significantly less depressed than victims in the AC group and had significantly less severe reexperiencing symptoms.

4) Title: Behavioural treatments in post-traumatic stress disorder.

Author: Lovell K; Richards D

Source: Br J Nurs, 1995 Sep 14-27, 4:16, 934-6, 953

Abstract: Post-traumatic stress disorder (PTSD) is increasingly becoming recognised as a serious mental health problem (Department of Health, 1991). Psychological treatments for PTSD remain in their infancy, though limited research has demonstrated the efficacy of behavioural and cognitive-behavioural interventions.

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