Trauma survivors’ perceptions and experiences of prolonged exposure for PTSD at a psychology clinic

Abstract

Background: Several trauma-focused treatments have been developed to treat post-traumatic stress disorder (PTSD). Yet there are limited studies on how trauma survivors perceive and experience trauma-focused treatments such as prolonged exposure therapy (PE) for PTSD, especially in low- and middle-income countries (LMIC).Aim: The study aimed to explore the perceptions and experiences of trauma survivors receiving prolonged exposure therapy for PTSD and the general acceptability of PE for PTSD in a LMIC.Setting: The study was conducted at a community psychology clinic in the Eastern Cape, South Africa.Method: Using a qualitative method, seven adult trauma survivors who completed six sessions of brief PE for PTSD were interviewed. Thematic analysis was used to identify relevant themes and to understand how participants perceived and experienced PE for PTSD.Results: The analysis yielded five themes, namely structure, obstacles, gender, exposure and experiences of recovery.Conclusion: The findings suggested that participants perceived and experienced PE to be generally beneficial for the treatment of PTSD. Moreover, the study suggested that PE is an acceptable trauma therapy in a contextually diverse setting such as the Eastern Cape, South Africa. Overall, considering the evidence base of PE for PTSD, this study contributed to the literature on the acceptability of PE in a South African setting.Contribution: The findings of the study are in keeping with the extant literature on how persons perceive and experience PE for PTSD. The findings of the study suggests that PE is an acceptable and beneficial trauma therapy for PTSD in a contextually diverse setting such as South Africa. It is recommended that large scale implementation studies be conducted to further investigate the effectiveness, feasibility, and acceptability of PE in South Africa.

Trauma-Informed Care in Psychedelic Therapy Research: A Qualitative Literature Review of Evidence-Based Psychotherapy Interventions in PTSD and Psychedelic Therapy Across Conditions

“…Once in treatment, some patients reported intentional behaviors aimed at making the most out of their treatment, cultivating a willingness to face fears associated with reliving their index-trauma. 50–52 , 81 , 82 , 84 , 85 , 89–95 In contrast, in the context of possessing a willingness to confront pain, some participants reported feeling incapable of engaging fully in imaginal exposure to traumatic events. This may be due to use of defenses, such as avoidance, and hesitancy about engaging in treatment due to psychosocial instability.…”

“…Studies highlighted the contribution of intrapersonal factors (eg, patient traits, beliefs, and internal resources) to the overall experience of treatment. [50][51][52]81,82,84,85,[89][90][91][92][93][94][95] Most studies referred to the significant psychological burden PTSD treatment entails (eg, fear of re-traumatisation, worsening of symptoms and functional destabilization). Correspondingly, in this synthesis, we found that intrapersonal factors reportedly influenced patients' perception of their experience of treatment, and conversely, their willingness to engage in often-challenging therapeutic processes.…”

“…Patients who responded to treatment described attaining insight into their persistent responses to internal states associated with their index-trauma. [50][51][52]81,[87][88][89][90]95,[99][100][101] Conversely, this may have also supported patients to feel validated and achieve a sense of mastery over their symptoms. Studies discussed the importance of cultivating selfawareness and possessing the capacity to notice "signals" 94 surrounding the need for self-regulation.…”

“…99 Experience of Self Patients described a range of positive and negative responses to PTSD treatment that affected their sense of trust and confidence in self. 70,85,89,90,95,101 In turn, this seemed, at times, to impact their belief in their ability to endure and benefit from the treatment. Patients described a gradual process characterised by noticing moderate positive changes or differences in their self-narratives, beliefs, and emotional responses.…”

“…So, let me just come back. 89 Correspondingly, patients also described how adverse responses to treatment negatively impacted their perception of self and capacity to utilise the treatment.…”