Harwood-Gross Anna, Elias Shir, Lerner Karen, Nacasch Nitsa, Lawi Cathy, Brom Danny, Barak Adi
Metiv Israel Psychotrauma Center, Herzog Medical Center, Jerusalem, Israel.
Leiden University Medical Center, Leiden University, Leiden, Netherlands.
Psychol Psychother. 2025 Mar;98(1):175-192. doi: 10.1111/papt.12570. Epub 2025 Jan 14.
Despite the proliferation of research into evidence based treatment for military PTSD there is little evidence for treatment assignment criterion and military based PTSD still demonstrates low remission rates.
Thirty participants in a randomized control trial comparing Prolonged Exposure (PE) and Somatic Experiencing (SE) were interviewed on their experiences in therapy and their responses assessed using a descriptive phenomenological analysis approach to delineate the central tenets of the two therapeutic approaches.
Results indicated that participants from both therapies covered themes of the experience of change, the experience of the therapeutic relationship and the therapeutic process. Within these themes, SE and PE participants reported both similar experiences, such as the predominance of physiological or bodily experiences and also described nuanced differences, specifically pertaining to therapy characteristics. SE participants described the process in terms of learning a language, applicable to alternative scenarios and PE participants described the process in terms of conquering exposures in order to achieve respite from symptoms.
The current findings have relevance in terms of presenting the key elements of the distinct trauma therapies and determining treatment appropriateness based on desired outcomes. They highlight the commonalities and differences between the patient experience in PE and SE, specifically the relevance of the bodily response, treatment expertise and therapist characteristics in both treatments. Understanding the unique elements of PE, a gold-standard PTSD treatment and SE, a novel somatic-based psychotherapy, will allow for better treatment preparation for participants and potentially aid treatment assignment.
尽管针对军事创伤后应激障碍(PTSD)的循证治疗研究大量涌现,但关于治疗分配标准的证据却很少,而且军事PTSD的缓解率仍然很低。
对一项比较延长暴露疗法(PE)和体感疗法(SE)的随机对照试验中的30名参与者进行访谈,了解他们的治疗经历,并采用描述性现象学分析方法评估他们的反应,以阐明这两种治疗方法的核心原则。
结果表明,两种疗法的参与者都涉及了改变体验、治疗关系体验和治疗过程等主题。在这些主题中,SE和PE参与者报告了相似的经历,如生理或身体体验占主导地位,也描述了细微的差异,特别是与治疗特点有关的差异。SE参与者将治疗过程描述为学习一种适用于其他场景的语言,而PE参与者将治疗过程描述为克服暴露以缓解症状。
目前的研究结果对于呈现不同创伤疗法的关键要素以及根据期望结果确定治疗适用性具有重要意义。它们突出了PE和SE中患者体验的共性和差异,特别是两种治疗中身体反应、治疗专业知识和治疗师特征的相关性。了解PE(一种PTSD的金标准治疗方法)和SE(一种基于身体的新型心理治疗方法)的独特要素,将有助于为参与者更好地准备治疗,并可能有助于治疗分配。