This article presents a literature review of the concept of continuous traumatic situations (CTS), which relates to residents living in ongoing situations of political violence and national security threats. The first aim of this review is to narrow the gap regarding knowledge about the concept of CTS by presenting findings from studies that have assessed the effects of CTS on civilian populations. The second aim is to describe CTS in a way that highlights the differences and similarities between posttraumatic stress disorder and responses to CTS. This distinction is a necessary precondition for examining CTS, as is a careful clinical analysis of the development and course of symptoms. This literature review also highlights the importance of adopting a supplementary perspective for understanding the psychological impact of ongoing exposure to real threats, which can be used as a basis for developing intervention strategies that are appropriate for coping with life in the context of persistent violence. CTS can be manifested as emotions, behaviors, and perceptions among individuals, families, communities, and societies. The nature of the proposed model of CTS is a circular one, combining past and future perceptions and emotional reactions that have resulted from continuous and repeated traumatic experiences over an extended period of time. This wider understanding reflects the complexity of the CTS phenomenon. Various micro and macro interventions relating to CTS as the result of political violence situations and national security threats are presented, and recommendations for practice, policy, and future research are offered.
Objective
Although trauma‐focused cognitive‐behavioral therapies (CBTs) for posttraumatic stress disorder (PTSD) have been applied worldwide, the nature of how these Western‐based interventions are applied in diverse settings has varied. This paper systematically reviewed the literature on how trauma‐focused CBTs have been applied and adapted cross‐culturally.
Method
A systematic review of studies that discuss the process of cultural adaptation of trauma‐focused CBTs.
Results
Seventeen papers were included and varied in the comprehensiveness of the adaptation process. Two studies stated that a theoretical framework was followed. Almost one‐third of the studies did not report whether local stakeholders were involved in the process of application. Fifteen studies examined the efficacy of the adaptations and the results were positive, but the methodology and quality varied.
Conclusion
There are inconsistencies in how trauma‐focused CBTs are culturally adapted. A systematic approach to the transportation of such therapies would enable greater investigation into the necessity and efficacy of such adaptations.
The findings show that our model of psychodynamic group therapy is associated with mental improvements in Veterans with PTSD. However, further randomized controlled trials are recommended to establish the advantages of our therapeutic method compared to other modes of therapy.
The efficacy of combat-related trauma-focused group therapy (TFGT) was tested using a unique technique that combines principles from prolonged exposure, cognitive processing therapy, and art therapy. Eighty Israeli male veterans exposed to traumatic events participated in the study. They were divided into eight therapeutic groups led by four pairs of trained therapists. Posttraumatic stress disorder and depression symptoms and levels of functioning were taken at pretherapy, end of therapy, and 6 months posttherapy. Analyses found that therapy helped in reducing posttraumatic and depressive symptoms at the end of therapy and at 6 months follow-up. It also showed that patients' functioning had significantly improved by the end of therapy and at 6 months follow-up. A significant clinical change in each parameter over time was also observed. In conclusion, the study provides preliminary evidence that combat-related TFGT may be efficacious in reducing psychological suffering and enhancing actual functioning. Follow-up randomized controlled trials to determine treatment efficacy are needed.
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