Pearce Michelle, Haynes Kerry, Rivera Natalia R, Koenig Harold G
Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
2South Texas Veterans Health Care System, San Antonio, Texas.
Glob Adv Health Med. 2018 Feb 20;7:2164956118759939. doi: 10.1177/2164956118759939. eCollection 2018.
Post-traumatic stress disorder (PTSD) is a debilitating disorder, and current treatments leave the majority of patients with unresolved symptoms. Moral injury (MI) may be one of the barriers that interfere with recovery from PTSD, particularly among current or former military service members.
Given the psychological and spiritual aspects of MI, an intervention that addresses MI using spiritual resources in addition to psychological resources may be particularly effective in treating PTSD. To date, there are no existing empirically based individual treatments for PTSD and MI that make explicit use of a patient's spiritual resources, despite the evidence that spiritual beliefs/activities predict faster recovery from PTSD.
To address this gap, we adapted Cognitive Processing Therapy (CPT), an empirically validated treatment for PTSD, to integrate clients' spiritual beliefs, practices, values, and motivations. We call this treatment Spiritually Integrated CPT (SICPT).
This article describes this novel manualized therapeutic approach for treating MI in the setting of PTSD for spiritual/religious clients. We provide a description of SICPT and a brief summary of the 12 sessions. Then, we describe a case study in which the therapist helps a client use his spiritual resources to resolve MI and assist in the recovery from PTSD.
SICPT may be a helpful way to reduce PTSD by targeting MI, addressing spiritual distress, and using a client's spiritual resources. In addition to the spiritual version (applicable for those of any religion and those who do not identify as religious), we have also developed 5 religion-specific manuals (Christianity, Judaism, Islam, Buddhism, and Hinduism) for clients who desire a more religion-specific approach.
创伤后应激障碍(PTSD)是一种使人衰弱的疾病,目前的治疗方法仍使大多数患者的症状无法得到缓解。道德损伤(MI)可能是妨碍从创伤后应激障碍中康复的障碍之一,尤其是在现役或退役军人中。
鉴于道德损伤的心理和精神层面,一种除心理资源外还利用精神资源来应对道德损伤的干预措施,可能在治疗创伤后应激障碍方面特别有效。尽管有证据表明精神信仰/活动预示着能更快从创伤后应激障碍中康复,但目前尚无基于实证的针对创伤后应激障碍和道德损伤的个体治疗方法明确利用患者的精神资源。
为填补这一空白,我们对认知加工疗法(CPT,一种经实证验证的创伤后应激障碍治疗方法)进行了调整,以整合来访者的精神信仰、实践、价值观和动机。我们将这种治疗方法称为精神整合认知加工疗法(SICPT)。
本文描述了这种新颖的、针对有精神/宗教信仰的来访者在创伤后应激障碍背景下治疗道德损伤的手册化治疗方法。我们对精神整合认知加工疗法进行了描述,并简要总结了12次治疗课程。然后,我们描述了一个案例研究,其中治疗师帮助一位来访者利用其精神资源解决道德损伤问题,并协助其从创伤后应激障碍中康复。
精神整合认知加工疗法可能是一种通过针对道德损伤、解决精神困扰并利用来访者的精神资源来减轻创伤后应激障碍的有效方法。除了通用的精神版本(适用于任何宗教信仰者和无宗教信仰者),我们还为希望采用更具宗教针对性方法的来访者开发了5本特定宗教手册(基督教、犹太教、伊斯兰教、佛教和印度教)。