Evidence Based Treatments for Trauma-Related Psychological Disorders: A Practical Guide for Clinicians

513 Pages·2015·8.2 MB·English

by  Ulrich Schnyder, Marylène Cloitre (eds.)

Evidence Based
Treatments for
Trauma-Related
PPssyycchhoollooggiiccaall DDiissoorrddeerrss
A Practical Guide
for Clinicians
Ulrich Schnyder
Marylène Cloitre Editors
123
Evidence Based Treatments for
Trauma- Related Psychological Disorders

Ulrich Schnyder (cid:129) Marylène Cloitre
Editors
Evidence Based
Treatments for
Trauma- Related
Psychological Disorders
A Practical Guide for Clinicians
Editors
Ulrich Schnyder Marylène Cloitre
Department of Psychiatry Dissemination and Training Division
and Psychotherapy National Center for PTSD
University Hospital Zurich San Franciso , California
Zurich USA
Switzerland
ISBN 978-3-319-07108-4 ISBN 978-3-319-07109-1 (eBook)
DOI 10.1007/978-3-319-07109-1
Springer Cham Heidelberg New York Dordrecht London
Library of Congress Control Number: 2015931248
© Springer International Publishing Switzerland 2015
T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection
with reviews or scholarly analysis or material supplied specifi cally for the purpose of being entered and
executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this
publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s
location, in its current version, and permission for use must always be obtained from Springer.
Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations
are liable to prosecution under the respective Copyright Law.
T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of
publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for
any errors or omissions that may be made. The publisher makes no warranty, express or implied, with
respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ulrich Schnyder and Marylène Cloitre
Part I Traumatic Stress: The Basic Principles
2 Trauma as a Public Health Issue: Epidemiology of Trauma
and Trauma- Related Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Sarah R. Lowe , Jaclyn Blachman-Forshay ,
and Karestan C. Koenen
3 Psychological and Social Theories of PTSD . . . . . . . . . . . . . . . . . . . . 41
Mirjam J. Nijdam and Lutz Wittmann
4 Neurobiological Findings in Post- traumatic Stress Disorder. . . . . . . 63
Iris-Tatjana Kolassa , Sonja Illek , Sarah Wilker ,
Alexander Karabatsiakis , and Thomas Elbert
5 Understanding Pathways from Traumatic Exposure
to Physical Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Paula P. Schnurr
Part II Stress and Trauma Related Disorders
6 The Diagnostic Spectrum of Trauma- Related Disorders. . . . . . . . . . 107
Richard A. Bryant
Part III Psychotherapy
7 Early Intervention After Trauma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Richard A. Bryant
8 Prolonged Exposure Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Carmen P. McLean , Anu Asnaani , and Edna B. Foa
9 Cognitive Therapy for PTSD: Updating Memories
and Meanings of Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Anke Ehlers and Jennifer Wild
v
vi Contents
10 Cognitive Processing Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Tara E. Galovski , Jennifer Schuster Wachen , Kathleen M. Chard ,
Candice M. Monson , and Patricia A. Resick
11 EMDR Therapy for Trauma-Related Disorders. . . . . . . . . . . . . . . . . 205
Francine Shapiro and Deany Laliotis
12 Narrative Exposure Therapy (NET): Reorganizing Memories
of Traumatic Stress, Fear, and Violence. . . . . . . . . . . . . . . . . . . . . . . . 229
Thomas Elbert , Maggie Schauer , and Frank Neuner
13 Brief Eclectic Psychotherapy for PTSD. . . . . . . . . . . . . . . . . . . . . . . . 255
Berthold P. R. Gersons , Marie-Louise Meewisse , and Mirjam J. Nijdam
14 STAIR Narrative Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Marylene Cloitre and Janet A. Schmidt
15 Complicated Grief Treatment (CGT) for Prolonged
Grief Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
M. Katherine Shear
Part IV Comorbidities
16 Trauma and Substance Abuse: A Clinician’s Guide
to Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Lisa M. Najavits
17 Treating PTSD and Borderline Personality Disorder. . . . . . . . . . . . . 331
Melanie S. Harned and Kathryn E. Korslund
18 The Complexity of Chronic Pain in Traumatized People:
Diagnostic and Therapeutic Challenges. . . . . . . . . . . . . . . . . . . . . . . . 347
Naser Morina and Niklaus Egloff
Part V Treating Special Populations
19 Evidence-Based Treatments for Children and Adolescents. . . . . . . . 363
Markus A. Landolt and Justin A. Kenardy
20 Treating PTSD Symptoms in Older Adults. . . . . . . . . . . . . . . . . . . . . 381
Maja O’Connor and Ask Elklit
21 Treatment of Traumatized Refugees and Immigrants. . . . . . . . . . . . 399
Thomas Maier
22 Considerations in the Treatment of Veterans
with Posttraumatic Stress Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . 413
Shannon E. McCaslin , Jessica A. Turchik , and Jennifer J. Hatzfeld
Contents vii
Part VI Special Treatment Modalities
23 Group Treatment for Trauma-Related Psychological Disorders. . . . 433
Scott D. Litwack , J. Gayle Beck , and Denise M. Sloan
24 Couple Treatment for Posttraumatic Stress Disorder . . . . . . . . . . . . 449
Candice M. Monson , Anne C. Wagner , Alexandra Macdonald ,
and Amy Brown-Bowers
25 Telemental Health Approaches for Trauma Survivors. . . . . . . . . . . . 461
Eric Kuhn , Julia E. Hoffman , and Josef I. Ruzek
Part VII Pharmacotherapy
26 Pharmacologic Treatment for Trauma- Related
Psychological Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479
Lori L. Davis , Laura J. Van Deventer , and Cherry W. Jackson
Part VIII Conclusions

27 What Works for Whom?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 499
Marylène Cloitre , Richard A. Bryant , and Ulrich Schnyder
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513
1
Introduction
Ulrich Schnyder and Marylène Cloitre
1.1 Why This Book?
Over the last three decades, the fi eld of traumatic stress-related research and clinical
practice has developed tremendously. In the aftermath of the war in Vietnam, s imilar
to other periods in recent history such as following World War I and World War II,
mental health professionals, policy makers, and the general public became aware of
the bio-psycho-social impact that overwhelming traumatic experiences can have on
both soldiers and the civilian population (Weisæth 2 014 ). However, unlike earlier
periods, this time the interest among professionals and the public did not abate and
has led to profound changes in government policies, mental health services, and
social perceptions. Never before has the trauma fi eld encountered such a long period
of ever-increasing interest among scientists as well as clinicians. The introduction
of the new diagnostic category of posttraumatic stress disorder (PTSD) in the DSM-
III in 1980 (APA 1980) sparked an unprecedented and, at least to some degree,
unexpected development. Few areas in mental health have enjoyed such a dynamic
and steady growth over the last 35 years. The number of trauma-related publications
in basic and clinical research, and thus the body of knowledge in the trauma fi eld,
has increased exponentially and continues to grow.
In parallel with the steady accumulation of basic knowledge, therapeutic approaches
have been developed to treat people suffering from PTSD and other trauma-related
U. Schnyder (*)
Department of Psychiatry and Psychotherapy , University Hospital Zurich ,
Zurich , Switzerland
e-mail: [email protected]
M. Cloitre
Dissemination & Training Division , National Center for PTSD ,
San Francisco , CA , USA
e-mail: [email protected]
© Springer International Publishing Switzerland 2015 1
U. Schnyder, M. Cloitre (eds.), Evidence Based Treatments for Trauma-Related
Psychological Disorders: A Practical Guide for Clinicians,
DOI 10.1007/978-3-319-07109-1_1
2 U. Schnyder and M. Cloitre
psychological problems. Today, a number of evidence-based psychological and phar-
macological treatments are available (Bisson et al. 2013; Bradley et al. 2005 ; Watts
et al. 2 013 ). Overall, effect sizes appear to be larger for psychotherapy as compared to
medication. Many well-controlled trials studying outcomes for a variety of trauma
survivors have demonstrated that trauma-focused psychotherapies are effective in
treating PTSD. Still, dropout rates are relatively high, and the majority of patients who
complete psychotherapy and/or pharmacotherapy still retain their PTSD diagnosis
and do not achieve good end-state functioning at posttreatment assessment. Therefore,
new developments are needed (Schnyder 2 005 ). One way forward is to further refi ne
well-established, empirically supported psychotherapies. By means of dismantling
studies, mechanisms of change can be established, the most effective treatment com-
ponents can be identifi ed, and less effective elements can be eliminated. In addition,
new and alternative therapies (psychopharmacological interventions, alternative or
complementary therapies) must be considered and systematically tested as should
strategies to increase access to mental health resources globally (e.g., the use of tech-
nology and telemental health approaches, Chap. 2 5 ).
So, why this book? There are so many excellent and up-to-date books already on
the market on various aspects of traumatic stress. However, most of these books are
either written by scientists for scientists or written by clinical practitioners for clini-
cal practitioners. The motivation for publishing yet another book lay in our desire to
edit a book written by clinically experienced researchers and scientifi cally trained
clinicians, a book fi rmly rooted in sound science but written in a language that
appeals to clinicians. The contributors to this book are writing for therapists in clini-
cal settings who may be academically trained but are primarily interested in how
they can best treat their traumatized patients.
This book offers an evidence-based guide for clinical psychologists, psychia-
trists, psychotherapists, and other clinicians working with trauma survivors in vari-
ous settings. It provides easily digestible, up-to-date information on the basic
principles of traumatic stress research and practice, including psychological and
sociological theories as well as epidemiological, psychopathological, and neurobio-
logical fi ndings. However, given the therapists’ aforementioned primary interest,
the core focus of the book is on evidence-based psychological treatments for
trauma-related mental disorders. Importantly, the full range of trauma and stress-
related disorders is covered, including acute stress reaction, complex PTSD, and
prolonged grief disorder, refl ecting important anticipated developments in the ICD-
11 diagnostic classifi cation. Additional chapters are devoted to the treatment of
comorbidities, special populations and special treatment modalities, and pharmaco-
logical treatments for trauma-related disorders. The book concludes by addressing
the fundamental question of how to treat whom and when.
1.2 The Content of the Book
Part I of the book lays the foundation for understanding the effects of trauma and
implications for treatment by providing a short and concise overview of the basic
principles of what we know today about traumatic stress. Starting with the