A clear pattern of natural recovery over time emerges. While the majority of assault victims show improvement over time, a minority still do not. For these individuals, effective treatment is available.
What is Prolonged Exposure Treatment?
Treatment Program
We are currently offering cognitive-behavioral treatment for:
Survivors of traumatic events such as a sexual assault, mugging, natural disasters, and car accidents can suffer from post-traumatic stress disorder (PTSD) and can continue to feel extreme anxiety and helplessness even long after the assault. Symptoms of PTSD include recurrent and distressing thoughts of the event, nightmares, extreme distress at reminders of the event, avoidance of trauma reminders, inability to feel a range of emotions (numbing), sleep disturbances, difficulty concentrating, and persistent anxiety/increased hypervigilance that were not present before the trauma. Symptoms tend to cluster in three areas:
PTSD can occur at any age, including childhood. PTSD-like symptoms are a common reaction immediately following a traumatic event. For the majority of trauma survivors, these symptoms decrease with time. Below is a prospective study of natural recovery. Ninety-six survivors of rape and 100 of non-sexual assault were assessed within 1 week following the assault and then repeatedly assessed every month for one year (Riggs et al., 1995; Foa et al., 1997).
A clear pattern of
natural recovery over time emerges. While the majority of assault victims
show improvement over time, a minority still do not. For these
individuals, effective treatment is available.
What is
Prolonged Exposure Treatment?
Prolonged exposure (PE) is a 9 to 12 session individual therapy that has been
shown to be effective in the treatment of PTSD. Of the available psychotherapies
used for PTSD, PE has undergone some of the most rigorous scientific
evaluation. Results of several controlled studies have shown it significantly reduce PTSD
and other symptoms such as anxiety and depression, particularly in women
following sexual and non-sexual assault (Foa et al., 1991; Foa et al., 1999).
PE is a type of cognitive behavioral treatment, which is
designed to specifically target a number of trauma-related difficulties. Clients
meet once a week with a therapist for 60 to 90 minutes. Treatment sessions
include: education about common reactions to trauma, breathing retraining (or
relaxation training), prolonged (repeated) exposure to trauma memories, repeated
in vivo (i.e., in real life) exposure to non-dangerous situations that are
avoided due to
trauma-related fear. In other words, clients are encouraged to confront the
memory of the trauma through repeatedly telling the story to the therapist and
to confront things in life that are avoiding because they are frightening (e.g.,
driving in a car, walking on the street at night).
Below is post-treatment data from a study conducted by Foa and colleagues (1999)
comparing prolonged exposure (PE), stress inoculation training (SIT; another
cognitive-behavioral therapy focusing on anxiety management techniques), and the
combination of PE and SIT, to a waitlist control (WL). Ninety-six sexual
and non-sexual assault survivors with chronic PTSD participated in this
study.
As seen above, PE, SIT, and SIT/PE, are more effective in reducing PTSD
diagnoses than the waitlist condition. Further, these treatment effects
last over time. Both PE and SIT are possible options for treatment, though
there is some slight indication that there may be some advantage of PE over SIT
(see Foa et al., 1999, for a discussion of this
data).
How do I receive
treatment?
Before entering a treatment program, clients are interviewed in detail. The information gathered during this evaluation is used to determine if the person has an anxiety or stress problem, and which treatment best matches the client's needs. The results of the evaluation are discussed with the client and treatment recommendations are offered. If it is decided that treatment program appropriate, arrangements will be made the end of the initial evaluation.
Please give Lori Zoellner, Ph.D., a call at (206) 685-3617 for more information on current programs. We will be offering free treatment for chronic PTSD for eligible men and women in the Spring of 2004.