Treating the Trauma of Rape Cognitive-Behavioral Therapy for PTSD

by Foa, Edna B.; Rothbaum, Barbara Olasov

• ISBN13: 9781572301788
• ISBN10: 1572301783
• Format: Hardcover
• Copyright: 1997-11-07
• Publisher: The Guilford Press

Summary

In the U.S. alone, approximately 1.5 million adult female survivors of rape are estimated to suffer from chronic PTSD. This invaluable book--informed by the latest research and written by two of the leading authorities in the field--provides a step-by-step guide to proven brief therapy techniques for treating traumatized women. Filling an urgent need of front-line practitioners working within managed care guidelines, the book includes numerous case examples illustrating sensitive and effective information-gathering and intervention, as well as explanations of how to cope with common problems and complications in treatment.

Author Biography

Edna B. Foa, PhD, Professor at the Allegheny University of the Health Sciences, Director of the Center for the Treatment and Study of Anxiety, is an internationally renowned authority on the psychopathology and treatment of anxiety. Her research aiming at delineating etiological frameworks and targeted treatment has been highly influential and she is currently one of the leading experts in the areas of posttraumatic stress disorders. The program she has developed for rape victims is considered to be the most effective therapy for post-trauma sequela. She has published several books and over 200 articles and book chapters, has lectured extensively around the world, and was chair of the PTSD work group of the DSM-IV. Dr. Foa is the recipient of numerous awards and honors, including the Distinguished Scientist Award from the Scientific section of the American Psychological Association, the First Annual Outstanding Research Contribution Award from the Association for the Advancement of Behavior Therapy, and the American Psychological Association Award for Distinguished Scientific Contributions to Clinical Psychology.

Table of Contents

I. WHAT DO WE KNOW ABOUT PTSD FOLLOWING ASSAULT?	3	(88)
1. The Clinical Picture: A Rape Victim and Her Father Tell Their Stories	3	(5)
The Father's Reaction to Learning of the Rape	3	(1)
Sarah's Disclosure to Her Family	4	(1)
The Father's Response to Sarah's Disclosure	4	(1)
Sarah's Description of the Rape	5	(1)
The Father's Continuing Reactions	6	(1)
Authors' Conclusion	7	(1)
2. Diagnosis and Prevalence of PTSD Following Assault	8	(19)
PTSD According to DSM-IV	8	(2)
Validity of the Three PTSD Symptom Clusters	10	(1)
Similarities and Differences between PTSD and Other Anxiety Disorders	11	(2)
The Symptom Picture of PTSD	13	(1)
Prevalence Studies	13	(7)
Acute and Chronic PTSD	20	(1)
Acute Stress Disorder: A New DSM Category	21	(1)
The Relationship between Acute Stress Reactions and PTSD	21	(3)
Dissociation, Numbing, and PTSD	24	(1)
Conclusion	25	(2)
3. Other Common Responses to Assault	27	(9)
Affective Reactions	27	(4)
Psychophysiological Reactions	31	(4)
Conclusion	35	(1)
4. What Do We Know about Treatment Efficacy for PTSD?	36	(32)
Interventions Shortly After the Trauma	36	(2)
Traditional Psychosocial Interventions	38	(5)
Pharmacological Interventions	43	(8)
Cognitive-Behavioral Interventions	51	(17)
5. Theoretical Bases for PTSD and Its Treatment	68	(23)
Theoretical Underpinnings of Cognitive-Behavioral Therapies for Anxiety Disorders	68	(2)
Personality and Social Psychology Theories	70	(2)
Emotional Processing Theory	72	(12)
How Do Cognitive-Behavioral Techniques Ameliorate PTSD?	84	(7)
II. HOW TO CONDUCT EFFECTIVE TREATMENT OF PTSD	91	(158)
6. An Overview of Cognitive-Behavioral Techniques and Programs for PTSD	91	(19)
An Overview of Treatment Planning Options	91	(1)
A Typical Treatment Program	92	(4)
Suggested Treatment Schedules	96	(14)
7. Assessment of PTSD and Related Problems	110	(11)
Goals for Assessment	110	(2)
Methods of Assessment	112	(6)
Problems in Assessment	118	(2)
Conclusion	120	(1)
8. The Beginning of Treatment	121	(23)
Session 1	121	(6)
Session 2 of Treatment	127	(17)
9. In Vivo Exposure: Confronting the Feared Situations	144	(14)
Presenting the Rationale for In Vivo Exposure	145	(1)
Explaining Habituation	145	(2)
Introduction to SUDs	147	(1)
Constructing a Hierarchy of Avoided Situations	147	(6)
Developing In Vivo Homework Assignments	153	(2)
Instructing the Client about the In Vivo Exposure Procedure	155	(1)
Using In Vivo Exposure in Sessions	156	(2)
10. Imaginal Exposure: Reliving the Trauma	158	(18)
Presenting the Rationale for Imaginal Exposure	159	(2)
The Imaginal Exposure Procedure	161	(4)
Additional Guidelines and Suggestions	165	(3)
Case Illustrations	168	(6)
Vicarious Traumatization of the Therapist	174	(2)
11. Cognitive Techniques I: Cognitive Restructuring	176	(22)
Theoretical Bases for Cognitive Restructuring	176	(5)
Presenting the Rationale for Cognitive Restructuring	181	(3)
Identifying "Trigger" Situations, Emotions, and Negative Thoughts or Beliefs	184	(3)
Challenging and Modifying Negative Thoughts or Beliefs	187	(5)
Identifying and Challenging Dysfunctional (Unhelpful) Assumptions	192	(6)
12. Cognitive Techniques II: Thought Stopping and Guided Self-Dialogue	198	(10)
Thought Stopping	198	(4)
Guided Self-Dialogue	202	(6)
13. Relaxation Training: Deep Muscle, Cue-Controlled, and Differential Relaxation	208	(9)
Deep Muscle Relaxation	209	(5)
Cue-Controlled Relaxation	214	(1)
Differential Relaxation	215	(1)
Practice and Homework	216	(1)
14. Role Play and Covert Modeling	217	(10)
Role Play	217	(6)
Covert Modeling	223	(4)
15. Common Problems, Termination, and a Full Case Example	227	(22)
Common Problems and Complications	227	(4)
Determining Whether the Client Needs More Sessions	231	(1)
Termination	232	(4)
Case Example: Betsy	236	(13)
Appendix: Assault Information and History Interview (AIHI)	249	(12)
References	261	(16)
Index	277