Feasibility and outcome of dialogical exposure therapy for posttraumatic stress disorder: A pilot study with 25 outpatients

Butollo, Willi; König, Julia; Karl, Regina; Henkel, Christine; Rosner, Rita

doi:10.1080/10503307.2013.851424

Cited by 18 publications

(5 citation statements)

References 22 publications

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“…Before attempting this large study, we conducted a pilot study of DET in an individual therapy setting with 25 treatment-seeking patients suffering from PTSD after adulthood trauma who received thirteen 90-min sessions of DET [25]. Pre-post effect sizes were large for PTSD symptoms ( d = 0.95 for the Impact of Event Scale - Revised, IES-R [26] and d = 0.70 for the Posttraumatic Diagnostic Scale, PDS [27]) and moderate for general psychopathology and interpersonal problems.…”

Section: Dialogical Exposure Therapy For Ptsdmentioning

confidence: 99%

A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood

Butollo

Karl²,

König³

et al. 2015

Psychother Psychosom

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Background: Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. Methods: We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Results: Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised; Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Conclusions: Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms.

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Section: Dialogical Exposure Therapy For Ptsdmentioning

confidence: 99%

A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood

Butollo

Karl²,

König³

et al. 2015

Psychother Psychosom

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“…All in all, we considered this first pilot trial as encouraging enough to further refine and evaluate our integrative approach to the treatment of traumatized populations. Meanwhile, results of an uncontrolled pilot study with patients suffering from PTSD showed promising results for dialogical exposure in an individual outpatient setting (Butollo, König, Karl, Henkel, & Rosner, ). A randomized controlled trial comparing DET to a well‐established cognitive–behavioural treatment manual is under way.…”

Section: Discussionmentioning

confidence: 99%

Dialogical Exposure with Traumatically Bereaved Bosnian Women: Findings from a Controlled Trial

Hagl

Powell²,

Rosner

et al. 2014

Clin Psychology and Psychoth

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Research attests to high levels of symptoms among post-war civil populations, in particular, when a loved one was killed, which can lead not only to trauma reactions but also to severe separation distress. Grieving the loss of a loved one is hampered if the death remains unconfirmed. Unconfirmed loss could be conceptualized as unfinished business in terms of Gestalt therapy, which offers empty-chair dialogue for resolving unfinished business and grief. Dialogical exposure therapy (DET) supports the client in gaining awareness of and expressing his or her inner dialogues concerning the traumatic event, using Gestalt empty-chair method. Short-term DET was effective in treating traumatically bereaved women but showed little additional effects in comparison with a supportive group treatment, so further research is warranted.

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“…The core component of the therapy is a modified form of empty chair work (Paivio and Greenberg, 1995), where the patient is invited to enter into a direct dialogue with the imagined perpetrator. DET has previously been tested in a group format with Bosnian women with traumatic bereavement (Hagl et al, 2015) and a pilot study (Butollo et al, 2014). More information on DET can be found in our original report (Butollo et al, 2016).…”

Section: Treatmentsmentioning

confidence: 99%

Difficulties in Conducting Long Term Follow Ups in Psychotherapy Research—Issues in the Literature and Data From a Randomized Therapy Comparison Study for Posttraumatic Stress Disorder

König¹,

Karl²,

Rosner³

et al. 2018

J Nerv Ment Dis

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Studies of psychotherapy for posttraumatic stress disorder (PTSD) typically encompass short follow-up periods, leading to a dearth of information on the long-term course of symptoms after treatment. We summarize existing long-term follow-up studies and highlight the issues making such research difficult. In this context, we report on a 2-year follow-up on a randomized treatment study comparing dialogical exposure therapy and cognitive processing therapy for adults with PTSD after type I trauma. Many of the problems connected to long-term follow-up also pertained to this study. Attrition was high, and the recruited sample was not representative of the study completers. Gains made during therapy were mostly stable, with no significant differences between interventions. At least for an originally successful subset of patients, the gains made during both treatments in our study tended to stay stable 2 years after the end of treatment.

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Feasibility and outcome of dialogical exposure therapy for posttraumatic stress disorder: A pilot study with 25 outpatients

Abstract: These results show that further research on DET as a treatment for PTSD is warranted.

Cited by 18 publications

References 22 publications

A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood

A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood

Dialogical Exposure with Traumatically Bereaved Bosnian Women: Findings from a Controlled Trial

Difficulties in Conducting Long Term Follow Ups in Psychotherapy Research—Issues in the Literature and Data From a Randomized Therapy Comparison Study for Posttraumatic Stress Disorder

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