School of Psychological Sciences, Monash University, Victoria, Australia.
Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia.
Early Interv Psychiatry. 2019 Oct;13(5):1236-1244. doi: 10.1111/eip.12761. Epub 2018 Dec 9.
Despite recommendations from national guidelines, individuals with first episode psychosis (FEP) are currently unlikely to have the effects of their traumatic experiences assessed and treated within psychosis treatment. This may be due to the mismatch between the objectives of trauma-specific treatments (directly targeting post-traumatic stress symptoms by talking about the trauma) and trauma-informed care (limiting practices that may retraumatise clients). We aimed to gain an understanding of what it was like for young people to talk about trauma in FEP treatment, and how their experiences related to the broad conceptualisations of trauma-informed and trauma-specific treatment approaches.
Semi-structured interviews were conducted with eleven participants (18-27 years) with FEP and post-traumatic stress disorder (PTSD) symptoms after the completion of an intervention for the effects of trauma. Transcripts were analysed using an interpretative phenomenological approach.
Two superordinate themes were identified, each with subordinate themes. 1. Reluctance to approach the trauma memory: 1a. Not wanting to talk about trauma; 1b. Difficulty acknowledging that the trauma had occurred; 1c. Not wanting to re-experience emotions associated with trauma. 2. Factors aiding the process: 2a. Desire for change; 2b. Not being pushed to talk; 2c. Valuing the case manager; 2d. Time.
A majority of participants in the study experienced reluctance when recounting their trauma memories. Being in control of how trauma memories are shared and having time for the therapeutic relationship to develop enhanced participants' readiness for talking about trauma. Incorporating trauma-informed principles and motivational interviewing could aid in facilitating the processes around talking about trauma.
尽管国家指南有相关建议，但目前患有首发精神病（FEP）的个体不太可能在精神病治疗中评估和治疗其创伤经历的影响。这可能是由于创伤特异性治疗（通过谈论创伤直接针对创伤后应激症状）和创伤知情护理（限制可能使客户重新受到创伤的做法）的目标不匹配所致。我们旨在了解年轻人在 FEP 治疗中谈论创伤的感受，以及他们的经历与创伤知情和创伤特异性治疗方法的广泛概念化有何关联。
对 11 名 FEP 和创伤后应激障碍（PTSD）症状患者（18-27 岁）在完成创伤影响干预措施后进行了半结构化访谈。使用解释现象学方法对转录本进行了分析。
确定了两个上级主题，每个主题都有下属主题。1. 不愿提及创伤记忆：1a. 不想谈论创伤；1b. 难以承认创伤已经发生；1c. 不想再次体验与创伤相关的情绪。2. 促进这一过程的因素：2a. 渴望改变；2b. 不被逼迫谈论；2c. 重视个案经理；2d. 时间。
研究中的大多数参与者在回忆创伤记忆时都感到不情愿。控制创伤记忆的分享方式，并为治疗关系的发展留出时间，这增强了参与者谈论创伤的准备程度。纳入创伤知情原则和动机性访谈可能有助于促进谈论创伤的过程。
