Beliefs, sense of control and treatment outcome in post-traumatic stress disorder.

Abstract

BACKGROUND:

Few studies have shown that maladaptive beliefs relate to treatment outcome.

METHOD:

In a randomized controlled study, 87 patients with post-traumatic stress disorder (PTSD) had exposure therapy alone or cognitive restructuring alone, or both combined, or relaxation. Independent blind assessors assessed patients at pre-, mid- and post-treatment and at follow-up; at those times patients rated cognitive, behavioural and emotional aspects of their disorder.

RESULTS:

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Thinking about risk : Can doctors and patients talk the same language?

Different mathematical expressions of risk are difficult enough for the doctor, but are likely to be harder for patients. Misselbrook and Armstrong showed that patients make very different choices about treatment depending on which of the above risk statistics they used as the basis of their judgement. Rather than empowering patients, such risk models can therefore make them yet more dependent on their doctors. Mathematical models are designed for the world of the doctor and do not fit easily with the world of the patient. So how can we proceed?

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Posttraumatic Re-experiencing in Older People : Working through or Covering up?

This paper is about the therapeutic approach to older people who suffer from war trauma experienced at an earlier age. Special attention is paid to posttraumatic re-experiencing and its role in treatment. First, a few examples of posttraumatic re-experiencing are described. These examples will be used to briefly illustrate some interpretation models, before devoting particular attention to one of them: the psychodynamic interpretation model. Then principles of therapy are discussed.

 

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