Treatment of a Multitraumatized Tortured Refugee Needing an Interpreter with Exposure Therapy

This paper described the application and feasibility of exposure therapy treatment (ET) for posttraumatic stress disorder (PTSD) in a multitraumatized tortured refugee with chronic PTSD and depression, in need of an interpreter. The patient received 26 one-hour sessions of ET involving exposure to his trauma-related memories. Symptoms of PTSD, depression, and anxiety were assessed at pre- and posttreatment and 3-, 6-, and 12-month followup with the Harvard Trauma Questionnaire (HTQ-R), PTSD Symptom Scale-Self Report (PSS-SR), Major depression inventory (MDI), and Beck Anxiety Inventory (BAI). Treatment led to a significant improvement across all measures of posttraumatic stress disorder, anxiety, and depression, and the improvement was maintained at the 12-month follow-up. The results from this case study provide further preliminary evidence that ET may be effective in treating multi-traumatized torture survivors who are refugees and in need of an interpreter, despite the additional stressors and symptoms complexity experienced by tortured refugees.

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Intensive EMDR to Treat Patients With Complex Posttraumatic Stress Disorder: A Case Series

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.11.2.84 ◽

2017 ◽

Vol 11 (2) ◽

pp. 84-95 ◽

Cited By ~ 11

Author(s):

Hannelies Bongaerts ◽

Agnes Van Minnen ◽

Ad de Jongh

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Case Series ◽

Self Report ◽

Complex Ptsd ◽

Symptom Scale ◽

Ongoing Research ◽

Research Attention ◽

Emdr Therapy

There is mounting evidence suggesting that by increasing the frequency of treatment sessions, posttraumatic stress disorder (PTSD) treatment outcomes significantly improve. As part of an ongoing research project, this study examined the safety and effectiveness of intensive eye movement desensitization and reprocessing (EMDR) therapy in a group of seven (four female) patients suffering from complex PTSD and multiple comorbidities resulting from childhood sexual abuse, physical abuse, and/or work and combat-related trauma. Treatment was not preceded by a preparation phase and consisted of 2 × 4 consecutive days of EMDR therapy administered in morning and afternoon sessions of 90 minutes each, interspersed with intensive physical activity and psychoeducation. Outcome measures were the Clinician-Administered PTSD Scale (CAPS) and the PTSD Symptom Scale Self-report questionnaire (PSS-SR). During treatment, neither personal adverse events nor dropout occurred. CAPS scores decreased significantly from pre- to posttreatment, and four of the seven patients lost their PTSD diagnosis as established with the CAPS. The results were maintained at 3-month follow-up. Effect sizes (Cohen’s d) on the CAPS and PSS-SR were large: 3.2, 1.7 (prepost) and 2.3, 2.1 (prefollow-up), respectively. The results of this case series suggest that an intensive program using EMDR therapy is a potentially safe and effective treatment alternative for complex PTSD. The application of massed, consecutive days of treatments using EMDR therapy for patients suffering from PTSD, particularly those with multiple comorbidities, merits more clinical and research attention.

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Patient perspectives on the effectiveness and tolerability of group-based exposure therapy for posttraumatic stress disorder: Preliminary self-report findings from 20 veterans.

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/a0029386 ◽

2013 ◽

Vol 5 (5) ◽

pp. 453-461 ◽

Cited By ~ 8

Author(s):

Juliette M. Mott ◽

Roy John Sutherland ◽

Wright Williams ◽

Stacey Holmes Lanier ◽

David J. Ready ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Exposure Therapy ◽

Patient Perspectives ◽

Self Report

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Is Trauma Memory Special? Trauma Narrative Fragmentation in PTSD

Clinical Psychological Science ◽

10.1177/2167702616676581 ◽

2017 ◽

Vol 5 (2) ◽

pp. 212-225 ◽

Cited By ~ 12

Author(s):

Michele Bedard-Gilligan ◽

Lori A. Zoellner ◽

Norah C. Feeny

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Prolonged Exposure ◽

Self Report ◽

Trauma Narrative ◽

Men And Women ◽

Chronic Ptsd ◽

Trauma Memory ◽

And Control

Seminal theories posit that fragmented trauma memories are critical to posttraumatic stress disorder (PTSD) and that elaboration of the trauma narrative is necessary for recovery. According to fragmentation theories, trauma narrative changes, particularly for those receiving trauma-focused treatment, should accompany symptom reduction. Trauma and control narratives in 77 men and women with chronic PTSD were examined pre- and posttreatment, comparing prolonged exposure (PE) and sertraline. Utilizing self-report, rater coding, and objective coding of narrative content, fragmentation was compared across narrative types (trauma, negative, positive) by treatment modality and response, controlling for potential confounds. Although sensory components increased with PE ( d = 0.23–0.44), there were no consistent differences in fragmentation from pre- to posttreatment between PE and sertraline or treatment responders and nonresponders. Contrary to theories, changes in fragmentation may not be a crucial mechanism underlying PTSD therapeutic recovery.

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