Cognitive-Behavioral Treatment of PTSD in Severe Mental Illness: Pilot Study Replication in an Ethnically Diverse Population

Lu, Weili; Fite, Rachael; Kim, Edward; Hyer, Leon A.; Yanos, Philip T.; Mueser, Kim T.; Rosenberg, Stanley D.

doi:10.1080/15487760802615863

Cited by 29 publications

(19 citation statements)

References 40 publications

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“…Ten studies (66.7%) (Callcott et al, 2004; Bernard et al, 2006; Kevan et al, 2007; Mueser et al, 2007, 2008; Frueh et al, 2009; Jackson et al, 2009; Lu et al, 2009; van den Berg and van der Gaag, 2012; Kayrouz and Vrklevski, 2015) reported on symptoms of depression. Four studies included measures of anxiety.…”

Section: Resultsmentioning

confidence: 99%

Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes

et al. 2017

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Individuals with severe mental health problems, such as psychosis, are consistently shown to have experienced high levels of past traumatic events. They are also at an increased risk of further traumatisation through victimization events such as crime and assault. The experience of psychosis itself and psychiatric hospitalization have also been recognized to be sufficiently traumatic to lead to the development of post-traumatic stress (PTS) symptoms. Rates of post-traumatic stress disorder (PTSD) are elevated in people with psychosis compared to the general population. The current guidance for the treatment of PTSD is informed by an evidence base predominately limited to populations without co-morbid psychiatric disorders. The systematic review therefore sought to present the current available literature on the use of psychological treatments targeting PTS symptoms in a population with a primary diagnosis of a psychotic disorder. The review aimed to investigate the effect of these interventions on PTS symptoms and also the effect on secondary domains such as psychotic symptoms, affect and functioning. Fifteen studies were identified reporting on cognitive behavior therapy, prolonged exposure, eye movement desensitisation and reprocessing and written emotional disclosure. The review provides preliminary support for the safe use of trauma-focused psychological interventions in groups of people with severe mental health problems. Overall, the interventions were found to be effective in reducing PTS symptoms. Results were mixed with regard to secondary effects on additional domains. Further research including studies employing sufficiently powered methodologically rigorous designs is indicated.

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Section: Resultsmentioning

confidence: 99%

Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes

et al. 2017

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“…Therefore, selection of which TFT is best suited for a particular treatment setting or population should be a function of the client's needs, feasibility for full implementation, the counselor's worldview, and the developmental level of counseling skills. In addition, consideration should be given to the client's cognitive abilities (Lu et al, ), the importance of spirituality as a component of recovery (Bowland, Edmond, & Fallot, ), and the potential for discontinuing treatment because of an adverse experience with repeated exposure to traumatic material.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Trauma-Focused Therapies for Treating the Symptoms of Posttraumatic Stress Disorder

Lenz

Haktanır

Callender

2017

Journal of Counseling & Development

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This meta-analysis of 46 between-groups studies published between 1997 and 2015 detected treatment effects ranging from large to small when comparing trauma-focused therapies with no treatment (g = -1.05), supportive interventions (g = -0.91), other interventions (g = -0.57), and non-trauma-focused cognitive behavior therapies (g = -0.08) for the treatment of posttraumatic stress disorder (PTSD). The independent random-effects models detected modest publication bias and a negligible influence of moderating variables on treatment outcomes. Considerations for counselors who treat PTSD and suggestions for researchers are provided.

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“…One supervisor (XXX) had formerly been a member of the clinical staff at one of the sites, where he had received training in the CBT program and had subsequently supervised clinicians at that site in implementing the program for a pilot study (11). The second supervisor (XXX) participated in a subsequent training in the CBT program, and treated one case with the program while receiving weekly supervision from one of the consultants prior to supervising the frontline clinicians for this project.…”

Section: Methodsmentioning

confidence: 99%

“…The program includes training in breathing retraining and education about PTSD, with a primary focus on teaching cognitive restructuring to address core beliefs related to trauma which are believed to underlie PTSD symptoms (10). Two pilot studies (11, 12) and one randomized controlled trial (13) support the feasibility and efficacy of this program.…”

mentioning

confidence: 89%

Use of Fidelity Assessments to Train Clinicians in the CBT for PTSD Program for Clients With Serious Mental Illness

Lu¹,

Yanos²,

Gottlieb

et al. 2012

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Objective Despite the growth in empirically supported interventions for the treatment of serious mental illness, these evidence-based practices are often not available to clients seeking services. One barrier to dissemination has been the difficulty of training frontline clinicians. This study was conducted to evaluate whether frontline clinicians could be trained to implement an empirically supported cognitive-behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) in persons with serious mental illness by providing them with session-by-session feedback on practice cases using a standardized fidelity measure. Method Twenty-five clinicians at five agency sites were trained in the CBT for PTSD program and delivered it to 35 practice cases over a 6-month period. Weekly feedback based on recorded sessions was provided to clinicians using the fidelity scale, with a criterion of competence established to designate “certification” in the program. PTSD and depression symptoms were monitored over the course of treatment for the practice cases. Results Two clinicians dropped out, and of the 23 clinicians, 21 (91%) achieved certification in the CBT program with their first case, and the remaining two (9%) achieved it with their second case. PTSD and depressive symptoms in clients decreased significantly during treatment, suggesting clinical benefits of the program. Conclusions The results support the feasibility of training frontline clinicians in the CBT for PTSD program using regular feedback based on the fidelity measure, and indicate that most clinicians can achieve competence in the model with a single practice case.

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Cognitive-Behavioral Treatment of PTSD in Severe Mental Illness: Pilot Study Replication in an Ethnically Diverse Population

Cited by 29 publications

References 40 publications

Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes

Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes

Meta-Analysis of Trauma-Focused Therapies for Treating the Symptoms of Posttraumatic Stress Disorder

Use of Fidelity Assessments to Train Clinicians in the CBT for PTSD Program for Clients With Serious Mental Illness

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