An open trial of exposure therapy based on deconditioning for post‐traumatic stress disorder

Abstract

Twenty-three patients who had experienced a major stressful event were given a debriefing session followed by eight weekly sessions of imaginal exposure and in vivo exposure. Patients recounted their traumatic experiences aloud, using the first person and the present tense, and included as much detail as possible. This account was audiotaped and patients were asked to listen to the tape between treatment sessions. There were reductions of 42 percent in the Impact of Events Scale (IES), of 61 percent in the General Health Questionnaire (GHQ), of 38 percent in the Symptom Checklist-90 (SCL-90) questionnaire, and of 35 percent in the Clinician Administered Post-Traumatic Stress scale (CAPS), all of which were statistically significant. The number of patients who satisfied the diagnostic criteria for post-traumatic stress disorder was halved.

Comparison of two treatments for traumatic stress: A community‐based study of EMDR and prolonged exposure

“…These researchers documented equivalent efficacy rates for both sequences of exposure techniques, reporting symptom reductions of 65 to 80%; no patient met criteria for PTSD at one-year follow-up. Thompson, Charlton, Kerry, Lee, and Turner (1995) reported a 35% symptom reduction per Clinician Administered PTSD Scale (CAPS; Blake et al, 1990) and a 42% reduction on the Impact of Events Scale (IES; Horowitz, Wilner, & Alvarez, 1979) scores following eight weekly sessions of exposure treatment. Numerous investigations also have demonstrated the efficacy of PE administered to PTSDdiagnosed veterans (e.g., Boudewyns, Hyer, Woods, Jarrison, & McCranie, 1990;Keane, Fairbanks, Caddell, & Zimmerman, 1989).…”

PSYCHOSOCIAL TREATMENTS FOR POSTTRAUMATIC STRESS DISORDER: A Critical Review

“…While the Richards et al study does not include a control group with which to compare the exposure conditions, nor blind evaluations with which to judge outcome, it does further support the use of exposure and provides information about the separate effects of the two exposure modalities, imaginal and in vivo. Thompson et al (1995) conducted an open trial of eight weekly sessions of imaginal and in vivo exposure treatment with 23 patients who had experienced various traumas. Patients met DSM-III-R criteria for PTSD based on the CAPS as well as a minimum threshold of symptom severity on several measures.…”

“…It did, however, include thorough assessments conducted with psychometrically sound instruments and a detailed and replicable treatment program. Like Thompson et al (1995), the Blanchard & Hickling study used a minimum threshold of PTSD symptom severity. This advantage is negated somewhat by the inclusion of patients with subsyndromal PTSD (i.e.…”

Perseveration of traumatic re-experiencing in PTSD; a cautionary note regarding exposure based psychological treatments for PTSD when head injury and dysexecutive impairment are also present

“…Typically, imaginal exposure to the traumatic event is conducted several times within a 1 hour session [22]. Exposure outside therapy is also often enhanced by using a taped narrative of the event which the patient is asked to listen to for up to 1 hour every day or every other day [22,23,25]. Some habituation on exposure is, therefore, assumed to take place generally within a maximum of 90 minutes and often within 20 minutes [20].…”