CBT TREATMENT OF PTSD

CBT Treatment of PTSD

Abstract

The present study investigated the efficacy of cognitive-behavior therapy (CBT) and exposure therapy (E) in the treatment of post-traumatic stress disorder (PTSD) in refugees. Sixteen outpatients fulfilling the DSM-IV criteria for PTSD were randomized to one of the two treatments. Assessor and self-report measures of PTSD-symptoms, generalized anxiety, depression, quality of life and cognitive schemas were administered before and after treatment, and at a 6-month follow-up. The patients were treated individually for 16-20 weekly sessions. The results showed that both treatments resulted in large improvements on all the measures, which were maintained at the follow-up. There was no difference between E and CBT on any measure. E and CBT led to a 48 and 53% reduction on PTSD-symptoms, respectively, a 49 and 50% reduction on generalized anxiety, and a 54 and 57% reduction on depression. The results were maintained at the 6-month follow-up. The conclusion that can be drawn is that both E and CBT can be effective treatments for PTSD in refugees.

Table of Content

Abstractii

CHAPTER 1: INTRODUCTION1

Outline of the Study1

Problem Statement1

Rationale2

Aims and Objectives3

Significance3

Research Question/Hypothesis4

Theoretical Frame work4

Limitation of the Study5

Ethical Concerns5

Reliability6

Validity7

CHAPTER 2: LITERATURE REVIEW9

Discussion16

Causes21

Risk Factors And Protective Factors for PTSD21

Treatment25

Outcome measures27

CBT and British culture28

CHAPTER 3: METHODOLOGY31

Research Design31

Sample31

Inclusion criteria31

Case Study33

Client Information34

Data Analysis35

Data Collection Method36

Data Analysis36

CHAPTER 04: DISCUSSION40

The subjects40

Assessor ratings41

Self-report scales41

Procedure42

Treatments :General aspects43

Exposure therapy (E)44

CBT44

Therapist45

Results46

Assessor ratings of PTSD -symptoms46

Self-report scales47

Change in use of medication49

Discussion50

A CASE DESCRIPTION: PATIENT 2 (TRAN)56

Culturally Adapted Treatment61

Step one: Identify key distress patterns61

Step two: ascertain how the key distress patterns are generated62

Step three: delineate fear networks62

Step four: design interventions to address specific manifestations of distress63

Step five: maximize cultural consonance63

Elements of Efficacy64

Limitations65

Summary66

CHAPTER 05: CONCLUSION67

References69

CHAPTER 1: INTRODUCTION

Outline of the Study

Post Traumatic Stress Disorder has been recognized as a major psychiatric disorder following emotional or physical trauma and manifests in the form of intrusive memories and nightmares associated with the precipitating event, avoidance behavior on being reminded of the event, recurrent insomnia and overt startle response (Bryant, 2007).If left undiagnosed or untreated it can lead to permanent psychological damage in the form of persistence of the symptoms described above.

Cognitive Behavior Therapy (CBT) incorporates some of the previously established elements of therapeutic approaches such as psychoeducation, problem solving strategies, skills teaching, modification of distorted cognitions and behaviorally based exposure methods (Smith et al, 1999).

Problem Statement

CBT has now attained the status as the 'treatment of choice' for PTSD according to a meta-analysis comparing it to drug treatments under a variety of control conditions (Monson et al, 2005). The general classes of CBT interventions for PTSD have now been divided into 'trauma-focused' and 'skills-focused' therapies. Insomnia subsequent to PTSD remains a lingering problem despite treatment by all modalities employed in CBT and needs additional interventions in the post treatment period (Deviva et al, 2005). A thorough follow up and observation after the essential interventions are therefore necessary after treating patients suffering from PTSD.

A negative event in one person's life can lead to either a rational belief which results in a 'healthy negative emotion', or it can lead to an irrational ...