Department of Psychology, University of Copenhagen, 2A Oester Farimagsgade, 1353, Copenhagen, Denmark.
Clinical Department of Eating Disorders, Mental Health Centre Ballerup, Mental Health Services in the Capitol Region of Denmark, Copenhagen, Denmark.
BMC Psychol. 2024 Mar 9;12(1):135. doi: 10.1186/s40359-024-01588-x.
Trauma-focused therapies (TFTs) are first-line treatments for posttraumatic stress disorder (PTSD). However, TFTs are under-utilised, partly due to clinicians' and patients' fear that TFT is too challenging or harmful. We review the qualitative studies on how adults with PTSD experience TFTs to enhance the understanding of user perspectives, therapeutic processes, and outcomes.
PubMed, PsychINFO and PTSDPubs were searched between October 1st and November 30th, 2021. Study quality assessments were undertaken, and studies were analysed using a descriptive-interpretative approach. Nine studies were included.
The analysis resulted in the identification of four key domains, representing a temporal sequence of TFT stages: Overcoming ambivalence towards TFT, Experience of treatment elements, Motivation for dropout/retention, and Perceived changes post-treatment.
Although many participants reported high levels of distress and considered dropping out, only a minority did eventually drop out and most patients expressed that the hardships in therapy were necessary for PTSD improvement. Establishing a safe therapeutic environment and working with the ambivalence towards treatment was essential for retention. This review serves a dual purpose, to shed light on diverse TFT experiences found to be important for treatment satisfaction, and to elucidate common treatment patterns. The results can be used in preparing patients for therapy and in training TFT therapists. Studies had moderate to high quality, and more studies of experiences of TFT non-responders and dropouts in a non-veteran population are needed to further our understanding of the utility and limitations of TFTs.
创伤聚焦疗法（TFT）是创伤后应激障碍（PTSD）的一线治疗方法。然而，TFT 的应用不足，部分原因是临床医生和患者担心 TFT 太难或太有害。我们回顾了成年人经历 TFT 的定性研究，以增强对用户观点、治疗过程和结果的理解。
2021 年 10 月 1 日至 11 月 30 日，在 PubMed、PsychINFO 和 PTSDPubs 上进行了搜索。对研究质量进行了评估，并使用描述性解释方法对研究进行了分析。共纳入 9 项研究。
分析结果确定了四个关键领域，代表了 TFT 阶段的时间顺序：克服对 TFT 的矛盾心理、治疗元素的体验、辍学/保留的动机、以及治疗后感知到的变化。
尽管许多参与者报告了高度的痛苦，并考虑辍学，但最终只有少数人辍学，大多数患者表示治疗中的困难是 PTSD 改善所必需的。建立一个安全的治疗环境并处理对治疗的矛盾心理对保留至关重要。本综述有双重目的，既要阐明对治疗满意度很重要的不同 TFT 体验，又要阐明常见的治疗模式。结果可用于为患者治疗做准备，并为 TFT 治疗师提供培训。研究质量为中等至较高，需要更多关于非退伍军人人群中 TFT 无反应者和辍学者经历的研究，以进一步了解 TFT 的实用性和局限性。
