Prolonged Exposure in the Treatment of PTSD Following an Apartment Fire

Abstract

Foa, Hembree, and Rothbaum's Prolonged Exposure treatment manual has been found to be an effective treatment modality for posttraumatic stress disorder (PTSD) that is comparable with other evidence-based PTSD treatments. Although the manual details weekly 90-min sessions, this time frame is not always feasible for those clinicians who may be confined to a 50-min appointment. In addition, Foa et al.'s inclusion of audio and video for taped exposures is not always possible given some centers' technological limitations and client finances. The current case summary details an adapted version of the manual that takes into account such limitations to treat a 26-year-old Jamaican-Canadian female who presented for treatment of PTSD following a fire destroying her home and possessions. Eighteen weekly 50-to 60-min sessions included components of psychoeducation, breathing retraining, in vivo exposures, imaginal exposures, and a trauma narrative (in replacement of audio/video exposures). From pre-to postassessment, significant gains were noted, including a reduction in intrusive thoughts and hyperarousal, and elimination of reexperiencing and sleep disturbances. At the conclusion of treatment, the client also demonstrated an ability to confront the trauma, memories, situations, activities, and places that she had avoided. Self-report measures further validated gains. Due to complicating factors, a follow-up evaluation was not able to be completed. Treatment complications, diversity factors, and implications for future work are discussed.

Preliminary Effectiveness of Brief Prolonged Exposure Therapy for PTSD: Expanding Access to Effective Therapies

“…To our knowledge, this is a first attempt to investigate the preliminary effectiveness of a brief PE treatment for PTSD among adults in South Africa. The results of the intervention are consistent with similar small sample intervention studies of PE for PTSD and adds to the literature on the implementation of PE in LMIC (e.g., Brand et al, 2020;Willis et al, 2015). The brief PE treatment resulted in symptom improvement for PTSD, depression, and anxiety among adults who sought trauma-focused therapy at two community-counseling centers in South Africa.…”

Adaptation and Integration of Psychosocial Stimulation, Maternal Mental Health and Nutritional Interventions for Pregnant and Lactating Women in Rural Bangladesh

“…In addition, the study followed a systematic adaptation process which included incorporation of feedback from participants and intervention facilitators throughout the revision process, consistent with the process of Goldstein et al [ 24 , 34 ]. These stages have also been applied in adaptation of an anger management intervention [ 35 ] and exposure therapy for the treatment of post-traumatic stress disorder [ 36 ]. In this paper we have described the intervention adaptation process.…”

Implementing Prolonged Exposure Therapy for PTSD in a Context of Ongoing Adversity: A Clinical Case Study

“…Rauch et al (2017) also evaluated the feasibility of a four-session PE model in primary health care settings. Finally, Willis et al (2015), without jeopardizing adequate fidelity, adapted minor elements of PE, such as not listening to exposure audio recordings at home, as participants did not have the financial resources.…”

“…For example, persons seeking services at primary care facilities may not always have the financial or social resources to attend long-term psychotherapy. Therefore, fidelity-consistent treatment modification needs to be explored to augment the dissemination and implementation of PE for PTSD (Willis et al, 2015).…”