Recent research offers good reason to think that various psychedelic drugs—including psilocybin, ayahuasca, ketamine, MDMA, and LSD—may have significant therapeutic potential in the treatment of various mental health conditions, including post-traumatic stress disorder, depression, existential distress, and addiction. Although the use of psychoactive drugs, such as Diazepam or Ritalin, is well established, psychedelics arguably represent a therapeutic step change. As experiential therapies, their value would seem to lie in the subjective experiences they induce.

Change in negative posttraumatic cognitions is a proposed mechanism through which Prolonged Exposure (PE) leads to symptom reduction of posttraumatic stress disorder (PTSD). A strong case for posttraumatic cognitions as a change mechanism in PTSD treatment can be made by establishing temporal precedence of change in cognitions. The current study examines the temporal relationship between change in posttraumatic cognitions and PTSD symptoms during PE, using the Posttraumatic Cognitions Inventory.

Current evidence-based therapies to treat trauma-affected populations, especially military members and first responders, have had variable success. Treatment response may be impeded by a lack of clinical attention to moral aspects of psychotrauma.

Het algemene doel van dit proefschrift was het verkennen en evalueren van nieuwe en methodische manieren om de langdurige behandeling van patiënten met een ernstige niet-psychotische psychiatrische aandoening, die door hun sociaal-psychiatrisch verpleegkundigen als moeilijk worden ervaren, te verbeteren. Daarbij was het belangrijk om inzicht te krijgen in waarom zij als moeilijk worden ervaren. Hoewel er verschillende antwoorden op de onderzoeksvragen zijn verkregen, komen er nieuwe en fundamentele vragen naar voren over de zorg voor deze groep patiënten.