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治疗伦敦市中心监狱中的多重创伤后应激障碍(PTSD):建立证据基础的必要性。

Treating Multiple Incident Post-Traumatic Stress Disorder (PTSD) in an Inner City London Prison: The Need for an Evidence Base.

作者信息

Campbell Catherine A, Albert Idit, Jarrett Manuela, Byrne Majella, Roberts Anna, Phillip Patricia, Huddy Vyv, Valmaggia Lucia

机构信息

King's College London,Institute of Psychiatry,and South London and Maudsley NHS Foundation Hospital Trust,London,UK.

South London and Maudsley NHS Foundation Hospital Trust,andUniversity College London,UK.

出版信息

Behav Cogn Psychother. 2016 Jan;44(1):112-7. doi: 10.1017/S135246581500003X. Epub 2015 Feb 20.

Abstract

BACKGROUND

Mental health problems have been found to be more prevalent in prison populations, and higher rates of post-traumatic stress disorder (PTSD) have been found in sentenced populations compared to the general population. Evidence-based treatment in the general population however has not been transferred and empirically supported into the prison system.

AIMS

The aim of this manuscript is to illustrate how trauma focused work can be applied in a prison setting.

METHOD

This report describes a two-phased approach to treating PTSD, starting with stabilization, followed by an integration of culturally appropriate ideas from narrative exposure therapy (NET), given that the traumas were during war and conflict, and trauma-focused cognitive behavioural therapy (TF-CBT).

RESULTS

PTSD and scores on paranoia scales improved between start and end of treatment; these improvements were maintained at a 6-month follow-up.

CONCLUSION

This case report 1 illustrates successful treatment of multiple incident PTSD in a prison setting using adaptations to TF-CBT during a window of opportunity when individuals are more likely to be free from substances and live in relative stability. Current service provision and evidence-based practice for PTSD is urgently required in UK prisons to allow individuals to engage in opportunities to reduce re-offending, free from mental health symptoms.

摘要

背景

研究发现,心理健康问题在监狱人群中更为普遍,而且与普通人群相比,被判刑人群中创伤后应激障碍(PTSD)的发病率更高。然而,普通人群中基于证据的治疗方法尚未被移植到监狱系统并得到实证支持。

目的

本手稿旨在说明如何在监狱环境中应用以创伤为重点的工作。

方法

本报告描述了一种分两阶段治疗创伤后应激障碍的方法,首先是稳定病情,鉴于创伤发生在战争和冲突期间,随后整合来自叙事暴露疗法(NET)以及以创伤为重点的认知行为疗法(TF-CBT)中适合文化背景的理念。

结果

在治疗开始和结束之间,创伤后应激障碍及偏执量表得分有所改善;这些改善在6个月的随访中得以维持。

结论

本病例报告表明,在个体更有可能摆脱药物影响并生活在相对稳定状态的机会窗口期间,通过对TF-CBT进行调整,成功地在监狱环境中治疗了多起事件引发的创伤后应激障碍。英国监狱迫切需要目前针对创伤后应激障碍的服务提供和循证实践,以使个体有机会减少再次犯罪,摆脱心理健康症状。

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