Brief treatment of complicated PTSD and peritraumatic responses in a client with repeated sexual victimization
The present case study describes the successful treatment of a woman with a history of sexual, physical, and psychological abuse in childhood and multiple rapes in adulthood, utilizing a relatively brief cognitive-behavioral treatment, Cognitive Processing Therapy (CPT). Treatment addressed assault-related PTSD, major depression, suicidality, compulsive self-harm behaviors, and primary and secondary dissociative responses. Treatment also addressed related issues of low self-esteem, social isolation, and the client's sense of helplessness, which had resulted in her failure to implement active self-protection strategies. Client symptomatology was tracked throughout treatment using the PTSD Symptom Scale (PSS) and the Beck Depression Inventory (BDI) at regular intervals over the course of 34 sessions and for 3 months posttermination. The relatively short course of therapy (22 weeks) and treatment strategies are described, including cognitive and behavioral components of CPT, supportive strategies, safety planning in the context of ongoing threats and victimization, and the importance of the therapeutic relationship. Particular emphasis is given to adaptation of the brief treatment to complex symptomatology and patterns of symptomatic change in relation to cognitive and behavioral intervention. Findings indicate that treatment for individuals with extensive victimization histories does not require different strategies or a significantly longer period of treatment than does treatment for those with a single traumatic experience.
Messman-Moore, TL; Resick, PA
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