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Exposure Therapy (exposure + therapy)
Selected AbstractsEfficacy of interpersonal therapy-group format adapted to post-traumatic stress disorder: an open-label add-on trialDEPRESSION AND ANXIETY, Issue 1 2010Rosaly F.B. Campanini MSc. Abstract Background: Post-traumatic stress disorder (PTSD) is a highly prevalent condition, yet available treatments demonstrate only modest efficacy. Exposure therapies, considered by many to be the "gold-standard" therapy for PTSD, are poorly tolerated by many patients and show high attrition. We evaluated interpersonal therapy, in a group format, adapted to PTSD (IPT-G PTSD), as an adjunctive treatment for patients who failed to respond to conventional psychopharmacological treatment. Methods: Research participants included 40 patients who sought treatment through a program on violence in the department of psychiatry of Federal University of São Paulo (UNIFESP). They had received conventional psychopharmacological treatment for at least 12 weeks and failed to have an adequate clinical response. After signing an informed consent, approved earlier by the UNIFESP Ethics Review Board, they received a semi-structured diagnostic interview (SCID-I), administered by a trained mental health worker, to confirm the presence of a PTSD diagnosis according to DSM-IV criteria. Other instruments were administered, and patients completed out self-report instruments at baseline, and endpoint to evaluate clinical outcomes. Results: Thirty-three patients completed the trial, but all had at least one second outcome evaluation. There were significant improvements on all measures, with large effect sizes. Conclusions: IPT-G PTSD was effective not only in decreasing symptoms of PTSD, but also in decreasing symptoms of anxiety and depression. It led to significant improvements in social adjustment and quality of life. It was well tolerated and there were few dropouts. Our results are very preliminary; they need further confirmation through randomized controlled clinical trials. Depression and Anxiety, 2010. © 2009 Wiley-Liss, Inc. [source] Effects of three PTSD treatments on anger and guilt: Exposure therapy, eye movement desensitization and reprocessing, and relaxation training,JOURNAL OF TRAUMATIC STRESS, Issue 1 2006Jennifer A. Stapleton This study sought to investigate the efficacy of prolonged exposure, eye movement desensitization and reprocessing, and relaxation training on trait anger and guilt and on trauma-related anger and guilt within the context of posttraumatic stress disorder (PTSD) treatment. Fifteen PTSD patients completed each treatment and were assessed at posttreatment and at 3-month follow-up. All three treatments were associated with significant reductions in all measures of anger and guilt, with gains maintained at follow-up. There were no significant treatment differences in efficacy or in the proportion of patients who worsened on anger or guilt measures over the course of treatment. Between-treatment effect sizes were generally very small. Results suggest that all three treatments are associated with reductions in anger and guilt, even for patients who initially have high levels of these emotions. However, these PTSD therapies may not be sufficient for treating anger and guilt; additional interventions may be required. [source] Review of assessment and treatment of PTSD among elderly American armed forces veteransINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2005Gina P. Owens Abstract Background The number of elderly combat veterans is steadily increasing in the US and estimates project that a notable percentage of these veterans experience symptoms of posttraumatic stress disorder (PTSD). Limited data exist specifically related to prevalence, assessment, and treatment of PTSD among the elderly veteran population. Objective This review summarizes the available research related to difficulties in assessment with the elderly American Armed Forces veteran population. In addition, both psychotherapeutic and pharmacological treatment interventions for PTSD are discussed. Methods A literature search was conducted using PsycINFO, Medline, and the National Center for PTSD's PILOTS database. Results Evidence suggests that elderly veterans generally present more somatic symptoms of PTSD. Medical and psychological comorbodities, such as depression, substance abuse, or cognitive deficits can further complicate the assessment process. Cut-scores for existing instruments need to be further established with elderly veterans. Use of exposure therapies with the elderly has not been adequately researched and mixed results have been obtained for supportive therapy for treatment of PTSD. Controlled research investigating pharmacological interventions for PTSD with the elderly is also limited. Conclusion Evidence suggests that some psychotherapeutic and pharmacological interventions already utilized with younger individuals may be useful with the elderly veteran population. However, research indicates that modifications may be required for working with the elderly population and further research in the areas of assessment and treatment are necessary. Copyright © 2005 John Wiley & Sons, Ltd. [source] Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunamiACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010T. Descilo Descilo T, Vedamurtachar A, Gerbarg PL, Nagaraja D, Gangadhar BN, Damodaran B, Adelson B, Braslow LH, Marcus S, Brown RP. Effects of a yoga breath intervention alone and in combination with an exposure therapy for PTSD and depression in survivors of the 2004 South-East Asia tsunami. Objective:, This study evaluated the effect of a yoga breath program alone and followed by a trauma reduction exposure technique on post-traumatic stress disorder and depression in survivors of the 2004 Asian tsunami. Method:, In this non-randomized study, 183 tsunami survivors who scored 50 or above on the Post-traumatic Checklist-17 (PCL-17) were assigned by camps to one of three groups: yoga breath intervention, yoga breath intervention followed by 3,8 h of trauma reduction exposure technique or 6-week wait list. Measures for post-traumatic stress disorder (PCL-17) and depression (BDI-21) were performed at baseline and at 6, 12 and 24 weeks. Data were analyzed using anova and mixed effects regression. Results:, The effect of treatment vs. control was significant at 6 weeks (F2,178 = 279.616, P < 0.001): mean PCL-17 declined by 42.5 ± 10.0 SD with yoga breath, 39.2 ± 17.2 with Yoga breath + exposure and 4.6 ± 13.2 in the control. Conclusion:, Yoga breath-based interventions may help relieve psychological distress following mass disasters. [source] Virtual reality exposure therapy for active duty soldiers,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2008Greg M. Reger Abstract Virtual reality exposure (VRE) therapy is a promising treatment for a variety of anxiety disorders and has recently been extended to the treatment of posttraumatic stress disorder (PTSD). In this article, the authors briefly review the rationale for VRE and its key processes. They illustrate the treatment with an active-duty Army soldier diagnosed with combat-related PTSD. Six sessions of VRE were provided using an immersive simulation of a military convoy in Iraq. Self-reported PTSD symptoms and psychological distress were reduced at posttreatment relative to pretreatment reports, as assessed by the PTSD Checklist,Military Version and the Behavior and Symptom Identification Scale,24. The case outcomes parallel those reported in the research with other disorders and suggest the applicability of VRE in treating active duty soldiers with combat-related PTSD. © 2008 Wiley Periodicals, Inc. J Clin Psychol: In Session 64:1,7, 2008. [source] Computer-supported cognitive behavioral treatment of anxiety disordersJOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2004Page Anderson This article reviews the empirical literature pertaining to the use of computer-supported cognitive-behavioral treatment of anxiety disorders, including palmtop computers, virtual reality exposure therapy, and personal computer software programs. The advantages and disadvantages unique to each type of technology are described. The review concludes with a discussion of ethical issues, barriers to the use of technology by clinicians, and suggestions for a process by which scientists and practitioners can conceptualize how technology can advance our understanding of anxiety and our dissemination of effective treatments. © 2004 Wiley Periodicals, Inc. J Clin Psychol. [source] Trauma focus group therapy for combat-related PTSD: An updateJOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2002David W. Foy Individual cognitive,behavioral therapy involving directed exposure to memories of traumatic events has been found to be effective in treating posttraumatic stress disorder. In this article, we present updated information on an alternative group form of exposure therapy: manualized trauma-focus group therapy (TFGT), designed as an efficient means of conducting directed exposure. We describe the cognitive,behavioral and developmental models from which the approach was derived, present an overview of session topics and a case illustration, provide guidelines for referring individuals to TFGT, and offer suggestions for future research. © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 907,918, 2002. [source] Is EMDR an exposure therapy?JOURNAL OF CLINICAL PSYCHOLOGY, Issue 1 2002A review of trauma protocols This article presents the well established theoretical base and clinical practice of exposure therapy for trauma. Necessary requirements for positive treatment results and contraindicated procedures are reviewed. EMDR is contrasted with these requirements and procedures. By the definitions and clinical practice of exposure therapy, the classification of EMDR poses some problems. As seen from the exposure therapy paradigm, its lack of physiological habituation and use of spontaneous association should result in negligible or negative effects rather than the well researched positive outcomes. Possible reasons for the effectiveness of EMDR are discussed, ranging from the fundamental nature of trauma reactions to the nonexposure mechanisms utilized in information processing models. © 2002 John Wiley & Sons, Inc. J Clin Psychol 58: 43,59, 2002. [source] Narrative exposure therapy for 7- to 16-year-olds: A randomized controlled trial with traumatized refugee children,JOURNAL OF TRAUMATIC STRESS, Issue 4 2010Martina Ruf The authors examined the effectiveness of narrative exposure therapy for children (KIDNET) in treating posttraumatic stress disorder (PTSD) in refugee children living in exile. Twenty-six children traumatized by organized violence were randomly assigned to KIDNET or to a waiting list. Significant treatment by time interactions on all PTSD-relevant variables indicated that the KIDNET group, but not the controls, showed a clinically significant improvement in symptoms and functioning. Success of the KIDNET group remained stable at 12-month follow-up. This study confirms previous findings that, if left untreated, PTSD in children may persist for an extended period. However, it also shows that it is possible to effectively treat chronic PTSD and restore functioning in traumatized refugee children in only 8 treatment sessions. [source] A field test of group based exposure therapy with 102 veterans with war-related posttraumatic stress disorder,JOURNAL OF TRAUMATIC STRESS, Issue 2 2008David J. Ready Group-based exposure therapy (GBET) was field-tested with 102 veterans with war-related posttraumatic stress disorder (PTSD). Nine to 11 patients attended 3 hours of group therapy per day twice weekly for 16,18 weeks. Stress management and a minimum of 60 hours of exposure was included (3 hours of within-group war-trauma presentations per patient, 30 hours of listening to recordings of patient's own war-trauma presentations and 27 hours of hearing other patients' war-trauma presentations). Analysis of assessments conducted by treating clinicians pre-, post- and 6-month posttreatment suggests that GBET produced clinically significant and lasting reductions in PTSD symptoms for most patients on both clinician symptoms ratings (6-month posttreatment effect size , = 1.22) and self-report measures with only three dropouts. [source] Dissemination of exposure therapy in the treatment of posttraumatic stress disorder,JOURNAL OF TRAUMATIC STRESS, Issue 5 2006Shawn P. Cahill Since the introduction of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1980), considerable research has demonstrated the efficacy of several cognitive,behavioral therapy (CBT) programs in the treatment of chronic PTSD. Among these efficacious treatments is exposure therapy. Despite all the evidence for the efficacy of exposure therapy and other CBT programs, few therapists are trained in these treatments and few patients receive them. In this article, the authors review extant evidence on the reasons that therapists do not use these treatments and recent research on the dissemination of efficacious treatments of PTSD. [source] Do patients drop out prematurely from exposure therapy for PTSD?JOURNAL OF TRAUMATIC STRESS, Issue 6 2003Elizabeth A. Hembree Abstract Many studies have demonstrated the efficacy of exposure therapy in the treatment of chronic posttraumatic stress disorder (PTSD). Despite the convincing outcome literature, a concern that this treatment may exacerbate symptoms and lead to premature dropout has been voiced on the basis of a few reports. In this paper, we examined the hypothesis that treatments that include exposure will be associated with a higher dropout rate than treatments that do not include exposure. A literature search identified 25 controlled studies of cognitive,behavioral treatment for PTSD that included data on dropout. The results indicated no difference in dropout rates among exposure therapy, cognitive therapy, stress inoculation training, and EMDR. These findings are consistent with previous research about the tolerability of exposure therapy. [source] Practitioner Review: Assessment and treatment of refugee children and adolescents who have experienced war-related traumaTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 12 2006Kimberly A. Ehntholt Background:, Increasingly clinicians are being asked to assess and treat young refugees, who have experienced traumatic events due to war and organised violence. However, evidence-based guidance remains scarce. Method:, Published studies on the mental health difficulties of refugee children and adolescents, associated risk and protective factors, as well as effective interventions, particularly those designed to reduce war-related post-traumatic stress disorder (PTSD) symptoms, were identified and reviewed. The findings are summarised. Results:, Young refugees are frequently subjected to multiple traumatic events and severe losses, as well as ongoing stressors within the host country. Although young refugees are often resilient, many experience mental health difficulties, including PTSD, depression, anxiety and grief. An awareness of relevant risk and protective factors is important. A phased model of intervention is often useful and the need for a holistic approach crucial. Promising treatments for alleviating symptoms of war-related PTSD include cognitive behavioural treatment (CBT), testimonial psychotherapy, narrative exposure therapy (NET) and eye movement desensitisation and reprocessing (EMDR). Knowledge of the particular needs of unaccompanied asylum-seeking children (UASC), working with interpreters, cross-cultural differences, medico-legal report writing and the importance of clinician self-care is also necessary. Conclusion:, More research is required in order to expand our limited knowledge base. [source] The Myth of the Superiority of Concurrent Combined Treatments for Anxiety DisordersCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 2 2010Kristin E. Pontoski [Clin Psychol Sci Prac 17: 107,111, 2010] The treatment of anxiety disorders with combined cognitive-behavioral therapy (CBT) and pharmacological treatments has been an ongoing topic of discussion. Combined treatments have failed to demonstrate additive benefits despite their continued use in practice. Otto, McHugh, and Kantak (2010) suggest that concurrent use of medication and CBT affects the acute release of cortisol during the extinction phase of exposure therapy and, in turn, interferes with memory consolidation. This commentary expands on some of the psychological aspects of combined treatments for anxiety disorders to consider along with this new biochemical perspective. [source] | |||||||||||||