Specialized Inpatient Trauma Treatment for Adults Abused as Children: A Follow-Up Study

Stalker, Carol; Palmer, Sally; Wright, David C.; Gebotys, Robert J.

doi:10.1176/appi.ajp.162.3.552

Cited by 30 publications

(27 citation statements)

References 15 publications

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“…had a strong effect. However, several studies that compared trauma-specific treatment including psychoeducation and affect regulation training under comparable residential conditions and a wait-list control group revealed only small to medium between-group effect sizes in patients whose PTSD resulted from childhood trauma [63,64,65]. …”

Section: Discussionmentioning

confidence: 99%

Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial

Bohus

Dyer²,

Priebe³

et al. 2013

Psychother Psychosom

289

250

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Background: Post-traumatic stress disorder (PTSD) with co-occurring severe psychopathology such as borderline personality disorder (BPD) is a frequent sequel of childhood sexual abuse (CSA). CSA-related PTSD has been effectively treated through cognitive-behavioural treatments, but it remains unclear whether success can be achieved in patients with co-occurring BPD. The aim of the present study was to determine the efficacy of a newly developed modular treatment programme (DBT-PTSD) that combines principles of dialectical behaviour therapy (DBT) and trauma-focused interventions. Methods: Female patients (n = 74) with CSA-related PTSD were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. About half of the participants met the criteria for co-occurring BPD. Individuals with ongoing self-harm were not excluded. The primary outcomes were reduction of PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS) and by the Posttraumatic Stress Diagnostic Scale (PDS). Hierarchical linear models were used to compare improvements across treatment groups. Assessments were carried out by blinded raters at admission, at end of treatment, and at 6 and 12 weeks post-treatment. Results: Under DBT-PTSD the mean change was significantly greater than in the control group on both the CAPS (33.16 vs. 2.08) and the PDS (0.70 vs. 0.14). Between-group effect sizes were large and highly significant. Neither a diagnosis of BPD nor the severity or the number of BPD symptoms was significantly related to treatment outcome. Safety analyses indicated no increase in dysfunctional behaviours during the trial. Conclusion: DBT-PTSD is an efficacious treatment of CSA-related PTSD, even in the presence of severe co-occurring psychopathology such as BPD.

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Section: Discussionmentioning

confidence: 99%

Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial

Bohus

Dyer²,

Priebe³

et al. 2013

Psychother Psychosom

289

250

View full text Add to dashboard Cite

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“…All had completed the six-week inpatient treatment program between September 1998 and February 2000. Detailed methodology for the larger study is reported in an earlier publication (Stalker, Palmer, Wright, & Gebotys, 2005). In summary, participants reported information about demographics; potentially traumatic experiences and abuse history at admission; and completed self-report outcome measures, at five points in time (admission, discharge, and 3, 6, and 12 months post-discharge).…”

Section: Methodsmentioning

confidence: 99%

“…The study also investigated what conditions, from their point of view, supported or interfered with their help-seeking behaviour. The findings presented here were gathered during a larger project that studied outcomes at several points following discharge from an inpatient trauma program at a small hospital in southwestern Ontario (Stalker, Palmer, Wright, & Gebotys, 2005). Clients participated in this program most often because their symptoms and distress were significantly interfering with their daily life functioning, and previous treatment (both inpatient and community-based) had not resolved the difficulties.…”

Section: Introductionmentioning

confidence: 99%

Adults traumatized by child abuse: What survivors need from community-based mental health professionals

Harper

Stalker

Palmer

et al. 2008

Journal of Mental Health

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Aims: To understand, from the ''insider'' perspectives of adults abused as children, the aspects of community mental health interventions that are experienced as helpful and less helpful after discharge from inpatient trauma treatment. Method: In-depth interviews were conducted with 30 child abuse survivors, six months after discharge from a specialized trauma treatment program. Results: Participants reported difficulties managing intense feelings that surfaced after inpatient treatment, which became more problematic when they could not talk about them honestly with their community-based therapists. Therapists who were patient, understanding, and respectful of survivors' needs for a sense of control in working toward their own solutions were most helpful. Participants emphasized the need for accessible trauma-based treatment from clinicians. Conclusions: Many communities in Canada, due to lack of resources, are not providing traumaspecific services. This study indicates that community-based therapists need to become more knowledgeable about trauma issues, to increase their ability to work collaboratively with adults abused as children in assessing their therapeutic needs, and to ensure that survivors have some control in the treatment process.

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“…The overall efficacy of the PTSR has been demonstrated in several studies conducted by two laboratories examining different treatment samples (Muller and Rosenkranz 2009;Stalker et al 2005;Rosenkranz and Muller 2011;Wright and Woo 2000;Wright et al 2003). These studies reported that symptoms generally decline to a moderate level over the course of the program, suggesting that clients are better equipped to be assisted by outpatient therapy following their discharge.…”

Section: Discussionmentioning

confidence: 99%

“…Included in this body of work are the studies of two separate research labs that examined the program investigated in the current study with three different patient samples and reported improvements at discharge in overall level of psychiatric symptoms (Stalker et al 2005), PTSD symptoms (Stalker et al 2005;Rosenkranz and Muller 2011;Wright and Woo 2000;Wright et al 2003), and attachment orientation (Muller and Rosenkranz 2009). These studies reported overall maintenance of treatment gains at 6-months and 1-year follow-up.…”

Section: Impact Of Trauma Severity and Poly-victimization On Treatmenmentioning

confidence: 99%

Trauma Severity, Poly-victimization, and Treatment Response: Adults in an Inpatient Trauma Program

2014

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The goal of the current study was to evaluate the extent to which abuse history predicted change in treatment in an inpatient setting. Poly-victimization and trauma severity were examined as predictors of treatment response measured by the Trauma Symptom Checklist-40 and the Symptom Checklist-90-R at admission, discharge, and 6-months follow-up. Data from 161 clients of an inpatient trauma treatment program were analyzed using structural equation modeling. Results indicate that level of poly-victimization predicted treatment response from admission to discharge on two of four outcome variables; however, this relationship was not found at follow-up. Further analyses suggest that the difference in treatment response at discharge among clients with higher rates of poly-victimization was an artifact of scores at admission. Trauma severity analyses reveal that differing types of abusive experiences generally did not predict treatment response. Overall, results demonstrate that this inpatient treatment program is similarly effective for a broad array of patients, including those with a greater number, and higher severity, of victimizations.

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Specialized Inpatient Trauma Treatment for Adults Abused as Children: A Follow-Up Study

Cited by 30 publications

References 15 publications

Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial

Dialectical Behaviour Therapy for Post-traumatic Stress Disorder after Childhood Sexual Abuse in Patients with and without Borderline Personality Disorder: A Randomised Controlled Trial

Adults traumatized by child abuse: What survivors need from community-based mental health professionals

Trauma Severity, Poly-victimization, and Treatment Response: Adults in an Inpatient Trauma Program

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