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客户在创伤聚焦认知行为疗法治疗创伤后应激障碍过程中经历再体验时的感受如何?

How do clients experience reliving as part of trauma-focused cognitive behavioural therapy for posttraumatic stress disorder?

机构信息

Isis Education Centre, Warneford Hospital, Oxford, UK.

出版信息

Psychol Psychother. 2011 Dec;84(4):458-75. doi: 10.1111/j.2044-8341.2010.02012.x. Epub 2011 May 18.

Abstract

OBJECTIVES

Reliving is an integral part of trauma-focused cognitive-behavioural therapy (CBT), a recommended treatment for post-traumatic stress disorder (PTSD) with a convincing evidence base supporting its use. However, the literature suggests that clinicians are reluctant to use reliving in therapy. The aim of this study was to explore participants' experiences of undergoing reliving as part of CBT for PTSD in order to further clinicians' understanding of client experiences of reliving.

DESIGN

This was a qualitative study. Semi-structured interviews were conducted and the transcripts analyzed using interpretative phenomenological analysis (IPA) (Smith, Jarman, & Osborn, 1999).

METHOD

Seven participants who had completed the reliving component of trauma-focused CBT in the previous month were recruited through therapists working in specialist trauma services, and semi-structured interviews were conducted using a topic guide. The transcripts were analyzed using IPA to enable the research questions to be addressed.

RESULTS

Three super-ordinate themes and 11 subordinate themes were developed to reflect participants' common and distinct experiences. The three super-ordinate themes were 'overcoming ambivalence', 'painful but achievable', and 'positive change'.

CONCLUSIONS

This study provided useful information about participants' experiences of reliving during CBT for PTSD. Clinical implications regarding the therapeutic relationship, preparing clients for reliving, and the impact of reliving were suggested. Implications for future research were identified including extending the score of the study, exploring differences in participants' experiences, and exploring unexpected findings.

摘要

目的

再体验是创伤焦点认知行为疗法(CBT)的一个组成部分,CBT 是创伤后应激障碍(PTSD)的推荐治疗方法,其使用有令人信服的证据支持。然而,文献表明临床医生不愿意在治疗中使用再体验。本研究的目的是探讨参与者在 PTSD 的 CBT 中经历再体验的体验,以便进一步了解客户对再体验的体验。

设计

这是一项定性研究。通过治疗师在专门的创伤服务机构中招募了 7 名在过去一个月内完成创伤焦点 CBT 中再体验部分的参与者,并使用主题指南进行了半结构化访谈。使用解释现象学分析(IPA)(Smith、Jarman 和 Osborn,1999)对转录本进行分析,以解决研究问题。

结果

开发了三个上位主题和 11 个下位主题,以反映参与者的共同和独特体验。三个上位主题是“克服矛盾心理”、“痛苦但可实现”和“积极变化”。

结论

本研究提供了有关 PTSD 的 CBT 中再体验参与者体验的有用信息。提出了关于治疗关系、为再体验做准备以及再体验的影响的临床意义。确定了未来研究的意义,包括扩展研究的得分、探索参与者体验的差异以及探索意外发现。

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