Therapie-Evaluation einer stationären Gruppe «Traumabewältigung» innerhalb der psychosomatischen Behandlung und Rehabilitation von Patientinnen mit chronischer PTB

Abstract

Given the high rates of both traumatic events and of resulting posttraumatic stress disorder (PTSD) it is imperative to develop and to evaluate efficacious and cost-effective treatment for these individuals. The clinic for behavioral medicine St. Franziska Stift in Bad Kreuznach, Germany, offers group treatment for traumatized inpatients who suffer from chronic PTSD. The group-therapy is based on cognitive processing therapy (CPT) originally developed by Resick and Schnicke (1993). This approach has been modified according to the demands of an inpatient treatment program and is conducted in a manualized approach by trained clinicians. The format and the therapeutic goals of that group are described. The treatment undergoes evaluation at the moment. 55 inpatients have been treated in the group so far. All but one patient have been severely sexually traumatized either in childhood, adulthood or at several stages in life. All patients suffer from PTB and a high comorbidity of mental disorder. The severity of PTB is assessed before, after group treatment and in a 3-month follow up. Dysfunctional beliefs that are affected by traumatization according to CPT are assessed before and after treatment. Results of 52 patients (pre and post assessment) and 42 patients (katamnestic data) are presented. Results indicate that PTSD declines significantly, furthermore dysfunctional beliefs that are targeted in the treatment change to more functional beliefs. Critical issues that occur in the treatment and difficulties in implementing inpatient treatment for multiple assault victims are discussed.

Effectiveness of a Multimodal, Day Clinic Group-Based Treatment Program for Trauma-Related Disorders: Differential Therapy Outcome for Complex PTSD vs. Non-Complex Trauma-Related Disorders

“…The observed reduction of depressive symptoms (and cPTSD symptoms for those patients with cPTSD) and increase in protective factors like PTG and perceived social support align with other studies describing positive treatment effects after different group-based therapy programs (14, 17, 18). Similar to our study, Lampe and colleagues (15) reported a reduction of depressive symptoms; PTSD scores did not differ significantly from those in the wait list group after their 6 week therapy program.…”

“…In a follow-up 2 years later, a significant reduction of overall symptom severity, PTSD, and depressive symptoms as well as an increase in self-calming ability were reported (16). Other examinations of inpatient treatment programs found significant improvements in dissociation, stress reaction and defense mechanisms (17), reductions of PTSD symptoms and improvements concerning feelings of self-esteem, freedom, and security (18) and improvements in PTSD, depressive and dissociative symptoms, as well as in interpersonal problems and general psychopathology (19). These improvements were found to be stable over a 1-year follow-up period.…”