Patient perspectives on the effectiveness and tolerability of group-based exposure therapy for posttraumatic stress disorder: Preliminary self-report findings from 20 veterans.

Abstract

Although an extensive body of empirical literature supports the efficacy of individual exposure therapy for posttraumatic stress disorder (PTSD), there is substantial debate about the suitability of exposurebased techniques in group treatment settings. Whereas some clinicians and researchers have predicted that these techniques may vicariously traumatize patients, others have argued that the group setting may facilitate exposure work by offering opportunities for normalization and social support. Few studies, however, have explored patients' opinions on group exposure. This study examined veterans' perspectives on the effectiveness and tolerability of a 12-week model of group-based exposure therapy (GBET) for PTSD. Analysis of qualitative and quantitative self-report data from 20 combat veterans indicated that participants were highly satisfied with GBET and experienced it as both helpful and acceptable. Eighty-five percent of the sample (n ϭ 16) evidenced reliable reductions in PTSD symptoms from preto posttreatment, without experiencing symptom exacerbation over the course of treatment. The observed dropout rate was low (5%, n ϭ 1), and treatment completers reported that commitment to the group was instrumental in their decision to remain in treatment. Veterans described that hearing other group members' in-session imaginal exposures had a normalizing effect, and they indicated that feedback from fellow veterans on their own imaginal exposures was the most helpful aspect of GBET.

Prolonged Exposure for PTSD in a Veteran group: A pilot effectiveness study

“…In addition to the review outlined above, several recent articles have examined new group exposure protocols (e.g., Castillo, C'de Baca, Qualls, & Bornovalova, 2012;Mott et al, 2013;Ready et al, 2008;Ready, Sylvers et al, 2012a;Sutherland et al, 2012). The majority of these studies Ready et al, 2008;Ready, Sylvers et al, 2012a;Sutherland et al, 2012) have relied on a similar manual (originally developed by Lorenz et al, 2006).…”

Post-Traumatic Stress Disorder & Treatment Approaches Adult Psychopathology

“…When the veterans expressed the potential benefits of GBET, a veteran stated, "I wanted to see how this would help me," while another said, "I had agreed to do this, and would not back out." The feedback supported the power of unity and that veterans were not only committed to themselves, or the GBET group but also in showing dedication and honesty staff members [2].…”

“…Referring to these promising benefits, others are augmenting extended GBET model settings [4]. A different approach to understanding GBET stems from a recent study (Mott et al, 2013), of receiving 20 combat veterans' perspectives of self-reporting GBET experiences. The concern that supports this approach is due to the substantial debate regarding GBET settings.…”

“…There are very few studies of combat veterans and what their opinions are of treatment and group exposure. These opinions are veteran's perspectives of a 12-week GBET for PTSD [2]. Of 20 veterans providing GBET feedback, 18 completed the survey.…”

Written Exposure Therapy as Step One in Reducing the Burden of PTSD: The Composite Cases of "Alex," "Bruno," and "Charles"

“…Several recent studies have examined outcomes from exposure-based therapies for PTSD within PCTs throughout the VA. In a retrospective chart review study, Mott et al (2013) found that Iraq and Afghanistan Veteran status as well as a history of psychiatric inpatient hospitalizations were associated with dropping out of Evidence Based Psychotherapy (i.e. Prolonged Exposure and Cognitive Processing Therapy).…”