Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-18T21:10:48.461Z Has data issue: false hasContentIssue false

Challenges in the Implementation of Manualized Psychotherapy in Combat-related PTSD

Published online by Cambridge University Press:  07 November 2014

Extract

Mr. F is a 60-year-old Caucasian, married, unemployed male who presented to the outpatient department of the Veterans Administration (VA) ∼10 months ago with a chief complaint of sleep difficulties. Approximately 12 years ago he had been diagnosed with posttraumatic stress disorder (PTSD) and a major depressive episode (MDE). He received very little treatment, either medication or therapy, at that time. He presented after being followed in a Veteran's Center for weekly to biweekly supportive therapy with a counselor for ∼6 months. He had gone to the Veteran's Center due to the encouragement of his wife. She had noted that he was becoming increasingly irritable and isolative at home and she had asked him to seek help for his anger and irritability. An event occurred in which he broke a chair after watching war-related news coverage and that made her insist that he present for treatment.

Type
Grand Rounds
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Foa, E, Hembree, E, Rothbaum, BO. Introductory information for therapists. Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences Therapist Guide. New York, NY: Oxford University Press; 2007:1.Google Scholar
2.Foa, E, Hembree, E, Rothbaum, BO. Introductory information for therapists. Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences Therapist Guide. New York, NY: Oxford University Press; 2007:12.Google Scholar
3.Foa, E, Hembree, E, Rothbaum, BO. Introductory information for therapists. Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences Therapist Guide New York, NY: Oxford University Press; 2007:19.Google Scholar
4.Herman, JL. Disconnection. Trauma and Recovery: The Aftermath of Violence: From Domestic Abuse to Political Terror. New York, NY: Basic Books; 1997:54.Google Scholar
5.Herman, JL. Disconnection. Trauma and Recovery: The Aftermath of Violence: From Domestic Abuse to Political Terror. New York, NY: Basic Books; 1997:64.Google Scholar
6.Gabbard, GO. Psychodynamic Psychiatry in Clinical Practice: the DSM-IV Edition. Washington, DC: American Psychiatric Press, Inc; 1994:276.Google Scholar
7.Gunderson, J, Sabo, A. The phenomenological and conceptual interface between borderline personality disorder and PTSD. Am J Psychiatry. 1993;150:1927.Google Scholar
8.Gabbard, GO; Psychodynamic Psychiatry in Clinical Practice: the DSM-IV Edition. Washington, DC: American Psychiatric Press, Inc; 1994:274.Google Scholar
1.Friedman, MJ, Marmar, CR, Baker, DG, Sikes, CR, Farfel, GM. Randomized, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting. J Clin Psychiatry. 2007;68(5):711720.Google Scholar
2.Hertzberg, MA, Feldman, ME, Beckham, JC, et al.Lack of efficacy for fluoxetine in PTSD: a placebo controlled trial in combat veterans. Ann Clin Psychiatry. 2000:12(2):101105.Google Scholar
3.van der Kolk, BA, Dreyfuss, D, Michaels, M, et al.Fluoxetine in posttraumatic stress disorder. J Clin Psychiatry. 1994;55(12):517522.Google Scholar
4.Raskind, MA, Peskind, ER, Hoff, DJ, et al.A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with posttraumatic stress disorder. Biol Psychiatry. 2007;61(8):928934.Google Scholar
5.Raskind, MA, Peskind, ER, Kanter, ED, et al.Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study. Am J Psychiatry. 2003;160(2):371373.Google Scholar
6.Foa, EB, Rothbaum, BO, Riggs, DS, Murdock, TB. Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling. J Consult Clin Psychol. 1991;59(5):715723.Google Scholar
7.Resick, PA, Nishith, P, Weaver, TL, et al.A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J Consult Clin Psychol. 2002;70(4):867879.Google Scholar
8.Foa, EB, Hembree, EA, Cahill, SP, et al.Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. J Consult Clin Psychol. 2005;73(5):953964.CrossRefGoogle ScholarPubMed
9.Schnurr, PP, Friedman, MJ, Engel, CC, et al.Cognitive behavioral therapy for posttraumatic stress disorder in women: a randomized controlled trial. JAMA. 2007;297(8):820830.CrossRefGoogle ScholarPubMed