scholarly journals A culturally adapted brief intervention for post-traumatic stress disorder in people with severe mental illness in Botswana: protocol for a randomised feasibility trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Keneilwe Molebatsi ◽  
Lauren C. Ng ◽  
Bonginkosi Chiliza

Abstract Background Research consistently reports elevated rates of exposure to traumatic events and post-traumatic stress disorder (PTSD) in people with severe mental illness (SMI). PTSD may be adequately managed with psychotherapy; however, there is a gap when it comes to management in culturally diverse settings like Botswana. This paper describes a study protocol whose aim is to culturally adapt the BREATHE intervention, a brief psychological intervention for people living with comorbid PTSD and SMI that was developed and tested in the USA; assess the feasibility and acceptability of the adapted BREATHE intervention and explore its efficacy. Methods The study will be conducted in three phases using a mixed methods approach. The first phase will identify and describe the most common traumatic experiences and responses to traumatic experiences, amongst patients with SMI, and patients’ and mental health care providers’ perceptions about suitable PTSD interventions for Botswana. The second phase will entail cultural adaption of the intervention using findings from phase 1, and the third phase will be a pilot trial to assess the feasibility and acceptability of the culturally adapted intervention and explore its efficacy. Quantitative and qualitative data will be analysed using basic descriptive statistics and thematic analysis, respectively. Discussion Literature highlights cultural variations in the expression and management of mental illness suggesting the need for culturally adapted interventions. The findings of this feasibility study will be used to inform the design of a larger trial to assess the efficacy of an adapted brief intervention for PTSD in patients with SMI in Botswana. Trial registration Clinicaltrials.gov registration: NCT04426448. Date of registration: June 7, 2020.

2015 ◽  
Vol 206 (6) ◽  
pp. 501-508 ◽  
Author(s):  
Kim T. Mueser ◽  
Jennifer D. Gottlieb ◽  
Haiyi Xie ◽  
Weili Lu ◽  
Philip T. Yanos ◽  
...  

BackgroundA cognitive–behavioural therapy (CBT) programme designed for post-traumatic stress disorder (PTSD) in people with severe mental illness, including breathing retraining, education and cognitive restructuring, was shown to be more effective than usual services.AimsTo evaluate the incremental benefit of adding cognitive restructuring to the breathing retraining and education components of the CBT programme (trial registration: clinicaltrials.gov identifier: NCT00494650).MethodIn all, 201 people with severe mental illness and PTSD were randomised to 12- to 16-session CBT or a 3-session brief treatment programme (breathing retraining and education). The primary outcome was PTSD symptom severity. Secondary outcomes were PTSD diagnosis, other symptoms, functioning and quality of life.ResultsThere was greater improvement in PTSD symptoms and functioning in the CBT group than in the brief treatment group, with both groups improving on other outcomes and effects maintained 1-year post-treatment.ConclusionsCognitive restructuring has a significant impact beyond breathing retraining and education in the CBT programme, reducing PTSD symptoms and improving functioning in people with severe mental illness.


2021 ◽  
Vol 2 (1) ◽  
pp. 1-12
Author(s):  
Esra Teke ◽  
Selahattin Avşaroğlu

The purpose of the present study is to examine the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for children and adolescents with post-traumatic stress disorder (PTSD). For this purpose, a framework was determined by using findings of the research and explanations at the conceptual level. PTSD is a mental disorder that is experienced after traumatic events, affects individuals cognitively, emotionally, and behaviorally and threatens the integrity of an individual's life. EMDR therapy is a therapy that imaginatively reveals the past or traumatic experiences of the client through eye movements and other bilateral stimuli (two-way sound or tactile stimulus), facilitates information processing processes. Whereas EMDR was initially an approach developed for adults, it was later used for children and adolescents. The fact that it gives positive results in a short time and these positive results continue in follow-up studies has increased the interest in using EMDR for children and adolescents with PTSD. The use of EMDR for children and adolescents has allowed their problems to be resolved in a timely manner and reduced PTSD symptoms. This situation has drawn attention to the importance of using EMDR in the practice of psychological counselors working in school environments, leading places where they work with children and adolescents, and where the first preventive and interventional studies are carried out. Therefore, it is considered that the use of EMDR will be functional in overcoming these negative life experiences of many students who have been directly or indirectly exposed to traumatic experiences during the COVID-19 epidemic period.


2020 ◽  
Author(s):  
Maria Malliarou ◽  
Dimitra Tsapakidi ◽  
Mairi Gouva ◽  
Evaggelia Kotrotsiou ◽  
Athanasios Nikolentzos ◽  
...  

Abstract Background The number of refugees and displaced people who have been forced to migrate due to war, mass violence and political instability has reached unprecedented levels. The objective of this study was to assess the degree of depression, resilience and post-traumatic stress disorder (PTSD) in asylum-seeker war refugees, temporally stationed in Larisa, Central Greece, through self-administered questionnaire. Simple regression, Pearson’s correlation coefficient and one-way Anova was used.Methods A cross-sectional study carried out with asylum-seeker war refugees residing in Larisa at a number of apartments rented and ran by the UNHCR and the municipality of Larisa. For the data collection PHQ-9 questionnaire, CD-RISC questionnaire and Harvard Trauma questionnaire (HTQ) were used. Descriptive statistics were applied, as well as Cronbach’s alpha coefficient.Results A total of 64 immigrants (40 males and 23 females, 1-mssing value) agreed to participate in the research. The mean age was 35.72 (SD 7.45), 35 respondents were classified as increased PTSD (scores > 2.5). The results showed a physically and exhausted sample, with marginal mental strength (Mean = 59.38%), fluctuating between moderate (N% = 28.10%) and severe depression (N% = 28.10%). About one in two participants (N% = 54.70%) showed signs of post-traumatic stress disorder PTSD, reporting traumatic experiences that mainly involved immediate events of violence, i.e. beating, while there were very few cases of sexual abuse or violence. A key factor in the formulation of PTSD, depression and Mental Stress Indicators was found to be age but limited to 43 years.Conclusion This study revealed that the refugees of the sample are tired, after being absent and idle for about 2 years from their homeland, in a marginal state of collapse. The most important event-hope that sustains its moderate resilience is the grant of asylum and the hope of arrival in the country of destination.


Literator ◽  
2018 ◽  
Vol 39 (1) ◽  
Author(s):  
Marisa Botha

This article analyses well-known anti-apartheid activist Winnie Madikizela-Mandela’s prison memoir 491 Days: Prisoner Number 1323/69 (2013) for depictions of suffering. This memoir reveals aspects of politically inflicted trauma, particularly the suffering sustained in prolonged solitary confinement and the resulting psychological sequelae for the prisoner. To move beyond a vague understanding of her traumatic experiences, this article draws on the field of psychiatry, specifically the diagnostic criteria for post-traumatic stress disorder (PTSD) to gain greater insight as this tool may also be regarded as a type of narrative that could aid in the comprehension of traumatic events. References will be made to the three main cluster symptoms of PTSD: involuntary re-experiencing of the traumatic event, avoidance of reminders and an ongoing sense of threat. An interdisciplinary literary-psychological approach will probably lead to a deeper understanding of the mental consequences of political imprisonment, as PTSD was not an acknowledged disorder during Madikizela-Mandela’s detainment.


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