Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The effectiveness of individually administered cognitive processing therapy (CPT) when compared with treatment as usual (TAU) in a community sexual assault centre was tested. Trauma survivors with acute stress disorder (ASD) following sexual assault were randomised to either CPT (n = 25) or TAU (n = 22), and assessed at pretreatment, posttreatment, and 3-, 6- and 12-month follow-up. Both groups demonstrated large reductions in PTSD and depression symptoms following treatment, and these gains were maintained over the course of follow-ups (Cohen's ds for PTSD symptom reductions ranging between 0.76 to 1.45). Although smaller and not always consistent, between-group effect sizes typically favoured CPT. Effect sizes (d) ranged between 0.13–0.50 for posttraumatic stress and 0.13–0.41 for depression over the course of follow-ups. Independent assessment of PTSD severity indicated more CPT participants reached good end-state functioning at 12-month follow-up (50%) than TAU (31%). Although both treatments were effective, there were some indications that CPT led to better outcomes relative to therapists delivering their usual therapy. The present study demonstrates that evidence-based, trauma-focused therapy such as CPT can be effective when delivered as an early intervention in a routine mental health setting.

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FC25-01 - Effects of additional exposure to psychoeducation and relaxation in acute stress disorder

European Psychiatry ◽

10.1016/s0924-9338(11)73656-2 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1953-1953

Author(s):

G. Sartory

Keyword(s):

Stress Disorder ◽

Prolonged Exposure ◽

Acute Stress ◽

Acute Stress Disorder ◽

Progressive Relaxation ◽

Trauma Network ◽

Significant Group ◽

Autonomic Responses ◽

Supportive Counseling

IntroductionMeta-analytic studies found exposure to be the most effective treatment in PTSD. Results are less clear with regard to acute stress disorder.ObjectivesTo evaluate the additional effect of exposure therapy to supportive counseling.AimsThe assessment of subjective measures and the heart-rate (HR) response to trauma reminders in the two treatment conditions.MethodsForty recent trauma victims with acute stress disorder were randomly assigned to three sessions of either prolonged exposure (PE) or supportive counseling (SC) with both groups also receiving psychoeducation and progressive relaxation. PE was administered imaginal and in vivo, both being therapist-assisted. Assessments were carried out before and after treatment and again after three months. Patients were shown ideosyncratic trauma-related pictures and autonomic responses assessed. Four years later, patients were asked by telephone whether they had required further treatment.ResultsThere were no significant group differences with regard to symptomatic improvement at the end of treatment. Before treatment both groups showed HR acceleration to trauma-related pictures. After treatment the PE group showed attenuation of the HR-response and a reduction of spontaneous skin conductance fluctuations (SF) whereas the SC group showed a decelerative (orienting) HR response and an increase in SF. Over the next four years 43% of the SC group and and 9% of the PE group required further treatment.ConclusionThe data show that SC, unlike PE, fails to attenuate autonomic responses to trauma-related stimuli suggesting that the former treatment fails to reorganize the trauma network.

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Cognitive-Behavioral Interventions for Disorders of Extreme Stress

The Oxford Handbook of Stress and Mental Health ◽

10.1093/oxfordhb/9780190681777.013.32 ◽

2018 ◽

pp. 672-688 ◽

Cited By ~ 1

Author(s):

J. Gayle Beck ◽

Allison M. Pickover ◽

Alexandra J. Lipiniski ◽

Han N. Tran ◽

Thomas S. Dodson

Keyword(s):

Cognitive Processing ◽

Behavioral Interventions ◽

Stress Disorder ◽

Prolonged Exposure ◽

Acute Stress ◽

Empirical Support ◽

Cognitive Behavioral ◽

Cognitive Processing Therapy ◽

Extreme Stress ◽

Behavioral Treatments

In this chapter, we review the current literature on cognitive-behavioral treatments for posttraumatic stress disorder (PTSD) and acute stress disorder (ASD). Particular attention is paid to treatments for PTSD that have strong empirical support, specifically cognitive processing therapy, prolonged exposure, and eye movement desensitization and reprocessing therapy. Cognitive-behavioral treatments for ASD have evolved differently, with greater emphasis on treatment packages; notably, this literature is less well developed and deserving of considerable more study, relative to the PTSD literature. Throughout the chapter, we have addressed areas for future study, as well issues that are currently salient in the treatment of these two conditions.

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