Reclaiming Your Life After Rape Cognitive-Behavioral Therapy for Posttraumatic Stress Disorder Client Workbook

by Rothbaum, Barbara Olasov; Foa, Edna B.

• ISBN13: 9780195183764
• ISBN10: 0195183762
• Edition: 1st
• Format: Paperback
• Copyright: 2004-11-11
• Publisher: Graywind Publications

Summary

This powerful client workbook is written in an encouraging and easy-to-understand style specifically for women who have been sexually assaulted and have developed chronic symptoms of posttraumatic stress disorder (PTSD). Clients learn how cognitive-behavioral therapy has helped other victimsand how it can work for them. This book explains how to distinguish PTSD symptoms from other disorders and teaches powerful techniques for overcoming these symptoms. In writing this book, the authors aim to address two goals. First, they want to present information about PTSD and related problems in language understandable to nonprofessionals. This information will include a review of the studies on posttrauma problems and on the effectiveness of differenttreatments. They also describe why some survivors develop PTSD and others do not. The second goal of the book is to provide a detailed client workbook for the treatment of trauma-related problems, especially PTSD, to assist clients working with a therapist. The authors are aware of the fact that people have different problems and different needs. What works for one person maynot work for another. Therefore, they describe several different treatment techniques. The book is organized around the different cognitive-behavioral techniques that have been studied and proven effective with women sufferers of PTSD following an assault. Throughout the book, the authors focus mainly on women who have been sexually assaulted and as a result developed chronic symptoms of PTSD, which have disturbed their daily functioning and cause them emotional distress. Most of the examples they use to demonstrate the cognitive-behavioraltechniques are drawn from their experience in treating rape survivors. However, the cognitive-behavioral procedures outlined here have been as successful in helping women who have been sexually abused in childhood and adult female survivors of nonsexual assaults, like aggravated assault androbbery. Other survivors of traumas such as natural disasters and car accidents were also helped by this cognitive-behavioral approach.

Table of Contents

Introduction	1	(6)
Section I. After the Assault
Overview of PTSD and Other Reactions
Case Descriptions	7	(8)
Sarah	7	(4)
Stephanie	11	(1)
Naomi	12	(3)
Posttraumatic Stress Disorder Following Assault	15	(6)
What is a Trauma?	15	(1)
What is Posttraumatic Stress Disorder?	15	(2)
The Symptoms of Posttraumatic Stress Disorder Following an Assault	17	(1)
The Course of PTSD in Trauma Survivors	18	(1)
The Prevalence of PTSD Among Trauma Survivors	18	(1)
Numbing, Dissociation, and PTSD	19	(1)
Conclusion	19	(2)
Other Reactions to Assault	21	(8)
Emotional Reactions	21	(8)
Depression	21	(1)
Anger	22	(1)
Shame	22	(1)
Dissociation	22	(1)
Social Problems	22	(1)
Sexual Problems	23	(1)
Trust	23	(6)
Section II. Assessing Personal Reactions
Common Reactions to Assault	29	(10)
Thoughts of Harming	37	(2)
Assessing My PTSD	39	(10)
Assessment of My Problems	39	(1)
Examples of Traumas	39	(1)
Rating of Posttraumatic Stress Disorder Symptoms	40	(2)
Usefulness of Assessment	42	(4)
Other Problems Associated With Assault	46	(3)
Depression	46	(1)
Substance Abuse or Dependence	46	(2)
Other Problems	48	(1)
What Do We Know About the Treatment of PTSD?	49	(10)
Crisis Intervention and Acute Posttraumatic Stress	50	(1)
Traditional Therapies	51	(8)
Hypnotherapy	51	(1)
Psychodynamic Treatments	51	(1)
Cognitive-Behavioral Therapy	51	(1)
Exposure	51	(1)
Systematic Desensitization	52	(1)
Prolonged Imaginal and In Vivo Exposure	53	(1)
Eye Movement Desensitization and Reprocessing	54	(1)
Anxiety Management Programs	54	(1)
Combined Treatment Programs	55	(1)
Pharmacological Treatments	56	(3)
Designing My Treatment Program	59	(6)
Overview of Three Treatment Programs	59	(2)
Exposure and Stress Inoculation Training Program	60	(1)
Exposure Program	60	(1)
Exposure and Cognitive Restructuring Program	60	(1)
Deciding Which Program is for Me	61	(1)
Obstacles to Change	62	(3)
Section III. Cognitive-Behavioral Program
Confronting The Traumatic Memories
Relaxation Training: Breathing Retraining, Deep Muscle Relaxation, Differential Relaxation	65	(8)
Breathing Retraining	65	(1)
Relaxation Training	66	(3)
Cue Controlled Relaxation	69	(1)
Differential Muscle Relaxation	70	(3)
Real-life Exposure: Confrontation of Feared Situations	73	(20)
Feared Situations Hierarchy and Subjective Units of Discomfort Ratings (SUDS)	73	(1)
Subjective Units of Discomfort	74	(1)
Avoided Situation Hierarchy Construction	75	(3)
Avoided Situation Homework Assignments	78	(1)
Case Example of Hierarchy Construction	79	(3)
About In Vivo Exposure Procedure	82	(9)
Safety Assessment During In Vivo Exposure Homework Assignment	91	(1)
Using In Vivo Exposure in Session	91	(2)
Imaginal Exposure: Reliving the Trauma Memory in Imagination	93	(14)
Rationale for Imaginal Exposure	93	(2)
The Imaginal Exposure Procedure: How to Practice It	95	(9)
Case Example 1: Emily	96	(5)
Case Example 2: Susan	101	(3)
Outline of Treatment Sessions	104	(3)
Section IV. Cognitive-Behavioral Program
Stress Management Techniques
Cognitive Techniques I: Cognitive Restructuring	107	(16)
Rationale for Cognitive Therapy	109	(2)
What is Cognitive Restructuring?	111	(1)
Overview of Steps for Cognitive Restructuring	111	(1)
Rationale for Cognitive Restructuring	112	(1)
Identification of Negative Thoughts and Beliefs	112	(1)
Three Important Points About Automatic Thoughts	113	(1)
Challenging Negative Thoughts	113	(3)
Common Cognitive Distortions	116	(1)
Examples of Cognitive Distortions	116	(1)
Demonstration of Using The Daily Diary	117	(3)
Identifying and Challenging Dysfunctional (Unhelpful) Assumptions	120	(1)
Summary for Challenging Negative Thoughts	120	(3)
Other Cognitive Techniques	123	(6)
About Thought-Stopping	123	(1)
Procedure for Thought-Stopping	123	(1)
Rationale for Guided Self-Dialogue	124	(5)
Role-play, Assertive Behavior, and Covert Modeling	129	(10)
About Role-play	129	(3)
Case Example of Assertive Feedback	132	(2)
About Covert Modeling	134	(5)
Section V. Cognitive-Behavioral Program
Putting It All Together
Putting the Techniques Together: Common Problems and Complications	139	(8)
Checking Progress	139	(4)
Common Problems and Complications	143	(4)
Avoidance/Resistance	143	(1)
Actual Risk	143	(1)
Compliance	144	(1)
Lack of Support	145	(1)
Other Disorders	145	(2)
Where Do I Go From Here?	147