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Gastrointestinal distress is a common symptom of anxiety. While these symptoms are usually transient and not severe, in some cases they can cause significant impairment. This report details the treatment of a 45-year-old male who presented with symptoms of diarrhoea and vomiting which occurred every time he travelled more than 10 miles away from his home. These symptoms arose suddenly and without warning, and on at least two occasions the vomiting was so severe that it caused the patient to vomit blood. Due to this problem, the patient had developed agoraphobia which had affected his life for over 15 years. The patient was treated in 14 sessions which involved educating him about gastrointestinal reactivity and having him perform a series of emotional tolerance, opposite-action, and real-life exposure exercises. After receiving treatment, the patient embarked on a series of vacations and business trips, all without experiencing diarrhoea or vomiting, and a follow-up assessment showed that the treatment gains were maintained 1 year later.
Given the personal and societal costs associated with acute impairment and enduring post-traumatic stress disorder (PTSD), the mental health response to disasters is an integral component of disaster response planning. The purpose of this paper is to explore the compatibility between cognitive-behavioral psychology and the disaster mental health model, and explicate how cognitivebehavioral perspectives and intervention methods can enhance the effectiveness of disaster mental health services. It is argued that cognitive-behavioral methods, if matched to the contexts of the disaster and the needs of individuals, will improve efforts to prevent the development of PTSD and other trauma-related problems in survivors of disaster or terrorist events. First, the similarities between models of care underlying both disaster mental health services and cognitive-behavioral therapies are described. Second, examples of prior cognitive-behavioral therapy-informed work with persons exposed to disaster and terrorism are provided, potential cognitive-behavioral therapy applications to disaster and terrorism are explored, and implications of cognitive-behavioral therapy for common challenges in disaster mental health is discussed. Finally, steps that can be taken to integrate cognitive-behavioral therapy into disaster mental health are outlined. The aim is to prompt disaster mental health agencies and workers to consider using cognitive-behavioral therapy to improve services and training, and to motivate cognitive-behavioral researchers and practitioners to develop and support disaster mental health response.
The mental health effects of disaster and terrorism have moved to the forefront in the recent past following the events of 11 September 2001 in the United States. Although there has been a protracted history by mental health researchers and practitioners to study, understand, prevent, and treat mental health problems arising as a result of disasters and terrorism, there still is much to learn about the effects and treatment of trauma. Continued communication among disaster workers, first-response medical personnel, and mental health professionals is part of this process. This paper outlines current knowledge regarding the psychological effects of trauma and best cognitive-behavioral practices used to treat trauma reactions. More specifically, the information presented is a summary of Cognitive-Behavioral Therapy (CBT) interventions that are relevant for responding to and dealing with the aftermath of disasters.
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