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简短折衷心理疗法治疗道德创伤(BEP-MT):治疗方案描述及案例研究。

Brief Eclectic Psychotherapy for Moral Trauma (BEP-MT): treatment protocol description and a case study.

机构信息

ARQ Centrum '45 , ARQ National Psychotrauma Center, Diemen, The Netherlands.

Department of Humanist Chaplaincy Studies, University of Humanistic Studies, Utrecht, The Netherlands.

出版信息

Eur J Psychotraumatol. 2021 Jul 5;12(1):1929026. doi: 10.1080/20008198.2021.1929026. eCollection 2021.

Abstract

: Traumatic events can be related to severe transgressions or violations of moral boundaries. Moral injury (MI) has been described as 'the lasting psychological, biological, spiritual, behavioral and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.' These events can provoke emotions such as remorse, guilt and shame, and affects someone's self-image and identity. : The aim of the study is to evaluate a treatment protocol that addresses the specific characteristics of moral trauma in treatment of PTSD, next to anxiety. : Brief Eclectic Psychotherapy for Moral Trauma (BEP-MT) is an adaptation of the evidence-based Brief Eclectic Psychotherapy for PTSD (BEPP). BEP-MT integrates components of cognitive-behavioural, psychodynamic, constructivist, and systemic psychotherapy. In the current study treatment progress of a refugee Dusan was monitored. Prior to and after treatment the Clinical-Administered PTSD Scale for DSM-5, the PTSD Checklist (PCL-5), the Brief Symptom Inventory (BSI) and the Moral Injury Appraisal Scale (MIAS) were administered. Every session moral emotions were assessed on a Likert scale. : Whereas PTSD complaints and strong feelings of guilt and shame were manifest prior to treatment, during BEP MT a gradual decline in the intensity of the moral emotions was found. After BEP-MT Dusan no longer met criteria for PTSD and his psychological complaints diminished. : The case of Dusan has shown it is worthwhile to address moral trauma and BEP- MT is a promising treatment protocol for patients suffering from PTSD after moral trauma. Further research is needed to examine the effectiveness of BEP-MT.

摘要

创伤性事件可能与严重的侵犯或违反道德界限有关。道德创伤(MI)被描述为“对违反深刻的道德信仰和期望的行为进行、未能防止或目睹这些行为的持久的心理、生物、精神、行为和社会影响”。这些事件会引发悔恨、内疚和羞耻等情绪,并影响一个人的自我形象和身份。

本研究旨在评估一种治疗方案,该方案针对 PTSD 治疗中道德创伤的特定特征,同时还针对焦虑。

道德创伤的简要折衷心理疗法(BEP-MT)是基于证据的 PTSD 简要折衷心理疗法(BEPP)的改编。BEP-MT 整合了认知行为、心理动力学、建构主义和系统心理疗法的组成部分。在目前的研究中,监测了一名难民杜桑的治疗进展。在治疗前和治疗后,使用 DSM-5 临床管理创伤后应激障碍量表、创伤后应激障碍检查表(PCL-5)、简要症状清单(BSI)和道德创伤评估量表(MIAS)进行评估。每次治疗都会在李克特量表上评估道德情绪。

尽管 PTSD 投诉和强烈的内疚和羞耻感在治疗前表现出来,但在 BEP-MT 期间,道德情绪的强度逐渐下降。在 BEP-MT 之后,杜桑不再符合 PTSD 的标准,他的心理投诉也减少了。

杜桑的案例表明,解决道德创伤是值得的,而 BEP-MT 是一种针对道德创伤后患有 PTSD 的患者的有前途的治疗方案。需要进一步研究来检验 BEP-MT 的有效性。

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