Department of Psychology, Bar Ilan University, Ramat Gan, Israel.
Psychology Department, Ben Gurion University, Beersheba, Israel.
J Trauma Stress. 2021 Feb;34(1):92-103. doi: 10.1002/jts.22537. Epub 2020 Jun 10.
Although empirically supported treatments for posttraumatic stress disorder (PTSD) exist, many patients fail to complete therapy, are nonresponsive, or remain symptomatic following treatment. This paper presents the results of a delayed intervention quasi-randomized controlled study that evaluated the efficacy of narrative reconstruction as an integrative intervention for PTSD. During narrative reconstruction, the patient and therapist reconstruct an organized, coherent, and detailed written narrative of the patient's traumatic experience. Additionally, narrative reconstruction focuses on arriving at the subjective meaning of the traumatic experience for the patient as related to their personal history. Thus, the therapist asks the patient about associations between the traumatic event and other memories and life events. In the present study, 30 participants with PTSD were randomly assigned to an immediate (n = 17) or delayed (n = 13) 15-session narrative reconstruction intervention. Participants in the immediate narrative reconstruction group were evaluated using self-report measures and structured interviews at baseline, posttreatment, and 15-week follow-up. Participants in the delayed narrative reconstruction group were evaluated at baseline, postwaitlist/pretreatment, and posttreatment assessments. Data from the pretreatment evaluation showed no significant differences between groups. Mixed linear models showed significant intervention effects for posttraumatic symptom severity, d = 1.17, from pre- to posttreatment. Although preliminary, these promising findings suggest that narrative reconstruction may be an effective standalone therapy or an add-on to current effective treatment strategies.
尽管创伤后应激障碍（PTSD）有经验支持的治疗方法，但许多患者未能完成治疗，对治疗无反应，或在治疗后仍有症状。本文介绍了一项延迟干预准随机对照研究的结果，该研究评估了叙事重建作为 PTSD 综合干预的疗效。在叙事重建过程中，患者和治疗师会对患者的创伤经历进行有组织、连贯且详细的书面叙述重建。此外，叙事重建侧重于确定创伤经历对患者的主观意义，以及与他们个人历史的关系。因此，治疗师会询问患者有关创伤事件与其他记忆和生活事件之间的关联。在本研究中，30 名 PTSD 患者被随机分配到立即（n = 17）或延迟（n = 13）接受 15 次叙事重建干预。立即接受叙事重建干预的患者在基线、治疗后和 15 周随访时使用自我报告量表和结构化访谈进行评估。延迟接受叙事重建干预的患者在基线、等待名单/治疗前和治疗后进行评估。治疗前评估的数据显示两组之间没有显著差异。混合线性模型显示，创伤后症状严重程度有显著的干预效果，d = 1.17，从治疗前到治疗后。尽管初步结果表明，叙事重建可能是一种有效的独立治疗方法，或作为当前有效治疗策略的附加治疗。
