How Effective Is Cognitive- Processing Therapy in Improving PTSD and Depressive Symptoms?

Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention: Empirical Evidence

“…They apply to all levels of intervention, from those focusing on the individual to those that are broadly community based. Clearly, we already have effective clinical interventions for survivors who develop PTSD (Foa et al, 1999;Resick et al, 2002) and for whom such treatment is accessible and acceptable. What is needed are more broad-scale interventions that inform primary and secondary prevention, psychological first-aid, family and community support, and community support functioning (Eisenbruch et al, 2004;de Jong, 2002a) (See Table 1).…”

“…On an individual level, studies of exposure therapy have found that a key to therapeutic success is to interrupt the posttraumatic stimulus generalization that links harmless images, people, and things to dangerous stimuli associated with the original traumatic threat (Bryant et al, 1998;Foa & Rothbaum, 1998;Gersons et al, 2000;Resick et al, 2002). This is done through both imagined exposure and real-world, invivo exposure in ways that re-link those images, people, and events with safety ("The bridge that collapsed as threatening, but all bridges are not" "That night was unsafe, but all nights are not unsafe.…”

“…Trauma-related self-efficacy pertains to the perceived ability to regulate troubling emotions and to solve problems that follow in the domains of relationships, restoration of property, relocating, job retraining, and other trauma-related tasks (Benight et al, 2000;Benight, Swift et al, 1999). In line with this thinking, interventions spanning from prevention of burnout (Freedy & Hobfoll, 1994) to work with victims of trauma (Resick et al, 2002) are founded in part on the proposition that people must feel that they have the skills to overcome threat and solve their problems.…”

“…Additionally, the very act of individual intervention by a mental health professional communicates the message that, with treatment, things will get better (i.e., "I'm an expert and I believe that you can succeed"). Interventionists are encouraged to normalize people's responses and to indicate that most people recover spontaneously (Foa & Rothbaum, 1998;Resick et al, 2002), as this in itself instills hope against distressing thoughts (e.g., "I'm going crazy," "I'm inadequate," "My reaction is a sign that I can't take it."). Early intervention can also foster hope by using such techniques as guided self-dialogue (Foa & Rothbaum, 1998;Meichenbaum, 1974) to underscore and restructure irrational fears, manage extreme avoidance behavior, control self-defeating selfstatements, and encourage positive coping behaviors.…”

“…Early CBT interventions have been found useful in counteracting these cognitive schemas (Bryant et al, 1998;Foa et al, 1995). Resick's (Resick et al, 2002) Cognitive Processing Therapy works to correct erroneous cognitions related to catastrophizing and self-labeling with traits that spell ultimate failure in coping. Paradoxically, envisioning a realistic, yet challenging, even difficult outcome may actually reduce people's distress, compared to envisioning an exaggerated catastrophic outcome.…”