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Posttraumatic Stress Disorder (PTSD)
Published in Judy Z. Koenigsberg, Anxiety Disorders, 2020
Are there other unified treatments for posttraumatic stress disorder (PTSD)? Another unified treatment approach for PTSD is the transdiagnostic unified protocol (UP) of Varkovitzky and colleagues (2018) who presented a UP for veterans who were diagnosed with posttraumatic stress disorder and different comorbidities. The UP, in harmony with prolonged exposure and cognitive processing therapy, can address emotion regulation in patients with several disorders such as anxiety and posttraumatic stress disorder (Barlow, Farchione et al., 2011; Varkovitzky et al., 2018). The aforementioned transdiagnostic treatment may suit clients and mental health professionals who wish to select a psychotherapy approach that is not trauma-focused in order to target a broad spectrum of symptoms and general dissatisfaction with life (Varkovitzky et al., 2018). The UP consists of an integration of approaches employed in cognitive-behavioral treatments that are empirically supported (Norton & Paulus, 2016; Varkovitzky et al., 2018). It was found that at the end of UP treatment, patients reported that they had fewer problems with emotion regulation, a decreased number of symptoms of posttraumatic stress disorder than they had prior to being treated with the UP, an increase in quality of life, and that the improvements in anxiety endured for at least a year and a half following UP treatment (Bullis, Fortune, Farchione, & Barlow, 2014; Carl, Gallagher, Sauer-Zavala, Bentley, & Barlow, 2014; Varkovitzky et al., 2018).
Post-Traumatic Stress Disorder in Vietnam Veterans
Published in Stephen M Cohn, Ara J. Feinstein, 50 Landmark Papers every Trauma Surgeon Should Know, 2019
Fast-forward 30 years and we face similar challenges in a new generation of combat veterans who have deployed since November 9, 2001, in support of the Global War on Terrorism. Only recently have the first randomized clinical trials been completed on the treatment of combat-related PTSD in active duty military personnel. Most of these studies were conducted by the Department of Defense-funded STRONG STAR Consortium (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience). STRONG STAR, headquartered in San Antonio, Texas, includes the collaboration of over 100 nationwide investigators and over 30 military, civilian, and VHA institutions. These studies have demonstrated that combat-related PTSD can be effectively treated with non-pharmacological cognitive behavioral therapies, such as cognitive processing therapy,7,8 prolonged exposure therapy,9 and abbreviated treatments using behavioral health consultants integrated into primary care settings.10-12 However, similar to Kolb's conclusion over three decades ago, much more research is still needed on the causes, prevention, and treatment of PTSD.
Writing for Wellness
Published in Meredith Mealer, Rowan Waldman, Coping with Caring, 2019
The WET protocol consists of five weekly 30-min writing sessions and is meant to reduce arousal and negative affect among individuals meeting diagnostic criteria for posttraumatic stress disorder (PTSD). It is theorized that confronting a traumatic memory through writing, instead of avoiding the traumatic memory, can provide emotional processing and fear extinction related to the event. What is so encouraging about WET is that it is a brief intervention. Clinical practice guidelines for the management of PTSD involve time-intensive psychotherapies that have a primary component of cognitive restructuring, prolonged exposure, and Cognitive Processing Therapy (CPT). As we learned in previous chapters, nurses have a high prevalence of PTSD and other psychological symptoms as a result of traumatic work experiences.
Challenges in Basic and Instrumental Activities of Daily Living among Adults with Posttraumatic Stress Disorder: A Scoping Review
Published in Occupational Therapy in Mental Health, 2023
Janne L. Punski-Hoogervorst, Avi Avital, Batya Engel-Yeger
None of the 20 included studies performed specific treatment interventions aimed to improve ADL among individuals with PTSD. However, three studies (15%) performed both a baseline and follow-up assessment and therefore would be able to provide data about the effects of treatment on the performance of ADL (Ahmadian et al., 2019; Shelef et al., 2019; Shnaider et al., 2014). Of these studies, one found that six months of equine-assisted therapy (3 h once a week) lead to a reduction of self-reported trauma-related symptoms, a significant improvement of active days, and a trend for less disturbance of daily life activities (Shelef et al., 2019). Another study found that cognitive processing therapy (twelve 60-min sessions over six weeks) lead to a reduction of PTSD symptom severity and improvement of basic and instrumental ADL: not only for the full therapy, but also for the cognitive-only and the writing-only interventions (Shnaider et al., 2014). The remaining study did not describe any treatment or therapy their participants may have had between the initial assessment and the follow-up (Ahmadian et al., 2019).
A Mixed-Methods Study of Clinician Adaptations to Parent-Child Interaction Therapy - What about Culture?
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2023
B. Erika Luis Sanchez, Corinna C. Klein, Frederique Corcoran, Miya L. Barnett
The findings in the current study have the potential to inform training supports for clinicians providing PCIT for culturally diverse clients with clinically complex presentations, in settings with possibly increased exposure to trauma, poverty, and systemic disadvantages. The current findings also support the need to diversify the provision of evidence-based mental health services, such as PCIT, to increase reach and acceptability among a diverse community of clients (Mokrue, 2022; The Justice Collective, 2021). Because the current study did not examine clinical outcomes (e.g., treatment completion, treatment engagement, reduction of symptoms, etc.), it is crucial that future studies evaluate the impact of cultural adaptations to community implemented EBPs, such as PCIT. In a study of the implementation of cognitive processing therapy, clients that received more fidelity-consistent adaptations to the protocol had greater reductions in depression and post-traumatic stress symptoms (Marques et al., 2019). Future implementation research on PCIT should study the impact of different types of adaptations to outcomes for ethnically and racially diverse clients, with the goal of understanding how to improve engagement and outcomes for traditionally underserved populations.
Eye movement desensitization and reprocessing for post-stroke post-traumatic stress disorder: Case report using the three-phase approach
Published in Brain Injury, 2022
There are a number of evidence-based treatments for PTSD. Several of these are cognitive and/or behaviorally based, such as cognitive processing therapy [CPT; Resick, Monson, & Chard, 13], prolonged exposure [PE; 14], and trauma-focused cognitive-behavioral therapy [TF-CBT; 15]. However, these approaches may not work for all patient populations, including those with co-occurring neurological disorders. For example, PE and CPT have been found to have substantial drop-out rates (16), which may be due to the aversive nature of the exposure. Managing dysregulation that can arise from exposure to traumatic material may be further challenged in persons with neurological disorders who are experiencing neurological dysregulation, such as pseudobulbar affect (17). Additionally, CBT-oriented approaches such as CPT and TF-CBT may be limited by their reliance on verbal expression of trauma narratives, which could be compromised in certain patients such as those with post-stroke aphasia or other cognitive impairments (18). Finally, the recent APA guidelines for the treatment of PTSD (19) have been criticized as being too cognitive/behaviorally focused (20) and may lack ecological validity for many persons with trauma (21), including those with more complex trauma presentations such as child abuse histories.