A mental healthcare model for mass trauma survivors : control-focused behavioral treatment of earthquake, war, and torture trauma

Half-title......Page 3
Title......Page 5
Copyright......Page 6
Dedication......Page 7
Contents......Page 9
Preface......Page 11
Acknowledgments......Page 12
Evolution of control-focused behavioral treatment......Page 13
Evidence base......Page 15
Part 3 – implications for care of mass trauma survivors......Page 18
References......Page 19
A learning theory model of traumatic stress......Page 23
Mental and physical health outcomes of trauma exposure......Page 25
Other factors contributing to traumatic stress reactions......Page 26
The initial major shock......Page 28
Quest for safety......Page 30
Reliance on safety signals......Page 32
Avoidance......Page 34
Fear of earthquakes: an evolutionary perspective......Page 35
Observational learning of fear......Page 36
Natural recovery processes and associated factors......Page 37
Helplessness and hopelessness effects of earthquakes......Page 40
Associations among helplessness, avoidance, and traumatic stress reactions......Page 42
Role of catastrophic cognitions in traumatic stress......Page 43
References......Page 45
Falling captive to an enemy: contextual factors......Page 51
Interrogation and helplessness-inducing psychological manipulations......Page 52
Physical torture......Page 54
Psychological responses to torture......Page 55
Coping with captivity and torture......Page 56
Natural recovery from captivity and torture trauma......Page 58
Evidence from studies of torture survivors......Page 59
Role of resilience and context of captivity in torturenduced distress......Page 60
Associations between resilience and sense of control during torture......Page 63
Contextual factors in captivity – stressor interactions......Page 64
Fear and helplessness effects of torture and their association with PTSD......Page 65
Fear and helplessness effects of war trauma......Page 66
Role of helplessness in war-elated PTSD......Page 68
Role of cognitive factors in war and torture trauma......Page 69
Concluding remarks......Page 71
References......Page 73
Traumatic stress symptom checklist (TSSC-E)......Page 77
Screening Instrument for Traumatic Stress in Earthquake Survivors – Child Version (SITSES-C)......Page 78
Fear and Avoidance Questionnaire (FAQ)......Page 79
Depression Rating Scale (DRS)......Page 80
Traumatic Stress Symptom Checklist (TSSC-W)......Page 81
Association between post-raumatic stress and perceived need for help......Page 82
Assessment of intervention outcomes......Page 86
Assessment of sense of control in treatment – Sense of Control Scale......Page 87
References......Page 88
Pre-reatment assessment......Page 91
Assessment of avoidance behaviors in earthquake survivors......Page 92
Assessment of avoidance behaviors in war and torture survivors......Page 93
Clarifying the need for treatment......Page 95
Explaining the treatment and its rationale......Page 96
Explaining how treatment works......Page 98
Overcoming fear of earthquakes......Page 101
Anti-avoidance instructions for war and torture survivors......Page 102
Focused selfxposure exercises......Page 103
Closing the session......Page 105
Therapist-administered live exposure......Page 106
Treatment of cases without fear as the prominent problem......Page 108
Comorbid depression......Page 109
Comorbid anxiety disorders......Page 110
Flashbacks......Page 111
Treatment of children......Page 113
Opening the session......Page 114
Single-Session Earthquake Simulation Treatment......Page 115
References......Page 120
Grief Assessment Scale and Behavior Checklist for Grief......Page 122
Step 1: identifying problem behaviors......Page 125
Step 2: explaining treatment and its rationale......Page 126
Step 3: defining exposure tasks and giving self-exposure instructions......Page 127
Subsequent sessions......Page 128
Defining closure for grief......Page 129
Case vignettes......Page 130
Preliminary evidence of treatment effectiveness......Page 133
Comparison of CFBT with other grief treatments......Page 134
References......Page 135
An open trial of controlocused behavioral treatment......Page 137
A randomized controlled trial of single-session CFBT......Page 139
A randomized controlled trial of Earthquake Simulation Treatment......Page 140
Comparison of CFBT with other treatments for PTSD......Page 141
CFBT delivered through a selfelp manual......Page 143
Treatment studies with children......Page 144
Mechanisms of recovery: anxiety reduction or increased sense of control?......Page 145
Aims in treatment......Page 149
Treatment procedures......Page 151
Concluding remarks......Page 152
References......Page 153
An outreach treatment delivery program......Page 155
Cost-effectiveness issues......Page 157
Applications of CFBT in primary care and outpatient settings......Page 158
Self-help manual......Page 159
Treatment dissemination through mass media......Page 161
Disseminating treatment knowledge......Page 162
Enhancing resilience to earthquake tremors: Earthquake Simulation Treatment......Page 163
Post-disaster phase......Page 164
Securing early resettlement of displaced survivors......Page 165
Concluding remarks......Page 166
References......Page 167
State of the art in treatment of trauma survivors......Page 169
Issues in survivor care in developing countries......Page 171
Care of earthquake survivors in industrialized countries......Page 172
Social recovery from mass trauma: potential role of mass media......Page 173
Intervention aims......Page 174
Levels of intervention......Page 175
Focus of interventions......Page 176
Timing of interventions......Page 177
Controversy regarding crossultural validity of PTSD......Page 178
Antidepressants in treatment of mass trauma survivors......Page 179
Implications for cognitiveehavioral treatment......Page 180
References......Page 182
State of the art in torture rehabilitation......Page 189
Immediate and long-term psychological impact of trauma......Page 190
Severity of mental health outcomes......Page 191
Attributions of blame and appraisal of impunity......Page 192
Response to treatment......Page 193
Lack of scientific approach to the problem......Page 199
Lack of evidenceased thinking......Page 202
Reinforcement of helplessness: ‘secondary victimization’......Page 203
Limitations of evidenceased treatments......Page 204
Role of funding organizations......Page 205
Potential problems in using evidence-based treatments in rehabilitation......Page 206
References......Page 207
Part I: Survivor Information Form......Page 211
Part II: – Traumatic Stress Symptom Cheklist (TSSC-E)......Page 212
Part III: Severity of Disability Scale (SDS)......Page 213
Part I: Survivor Information Form......Page 214
Part II: – Traumatic Stress Symptom Checklist – Child Version (TSSC-C)......Page 215
Part III: – Functional Impairment Scale......Page 216
Fear and Avoidance Questionnaire......Page 217
Depression Rating Scale......Page 219
Part I: Survivor Information Form......Page 220
Part II: Traumatic Stress Symptom Checklist (TSSC-W)......Page 221
Part III: Severity of Disability Scale (SDS)......Page 222
Global Improvement Scale – Assessor (GIS-A)......Page 223
Workthinsp/thinspSocial Adjustment Scale (SELF-RATED)......Page 224
Workthinsp/thinspSocial Adjustment Scale (ASSESSOR-RATED)......Page 225
Sense of Control Scale......Page 226
Grief Assessment Scale......Page 227
Behavior Checklist for Grief......Page 228
About the Authors......Page 229
References......Page 230
Avoidance......Page 231
Depression......Page 232
Is fear of earthquakes normal?......Page 233
How do people cope with fear?......Page 234
Section 2: Assessing traumatic stress problems......Page 235
Assessing severity of fear and avoidance......Page 236
Ruling out conditions that require attention by a specialist......Page 238
Summary of assessment procedures......Page 240
Step 1: Explaining treatment......Page 241
Step 2: Giving antivoidance instructions......Page 242
Step 3: Giving homework exercises......Page 243
Involving close ones in treatment......Page 245
Evaluating improvement in traumatic stress problems......Page 246
Confronted fearedthinsp/thinspdistressing situations but felt no distress or fear......Page 247
Session 3......Page 248
Worsening of depression during treatment......Page 250
Flashbacks during homework exercises......Page 251
Summary of treatment procedures......Page 252
Section 5: Helping children......Page 253
Subsequent monitoring sessions......Page 254
Explaining the treatment......Page 255
Closing the session......Page 256
Assessing severity of grief symptoms......Page 257
Identifying problem behaviors......Page 258
Does normal grief need treatment?......Page 259
Step 2: Defining homework exercises......Page 260
Evaluating progress with homework exercises......Page 262
Providing direct assistance with homework exercises......Page 263
When can you expect improvement in treatment?......Page 264
Summary of treatment procedures for prolonged grief treatment......Page 265
About the Authors......Page 266
References......Page 267
Assessing traumatic stress problems......Page 268
Assessing grief......Page 270
Is this treatment suitable for you?......Page 272
What is avoidance behavior?......Page 273
How does fear contribute to traumatic stress problems?......Page 275
How do people cope with fear?......Page 276
Beating your fear of buildings......Page 277
Beating distress caused by trauma reminders......Page 279
What to do in case of difficulty with confronting distress......Page 280
Evaluating progress in treatment......Page 281
When to expect improvement in treatment......Page 282
Step 1: Identify problem behaviors......Page 283
Step 3: Work on your tasks......Page 284
Evaluate your progress in treatment......Page 285
When can you expect improvement in treatment?......Page 286
Dealing with increased stress symptoms......Page 287
Dealing with flashbacks during treatment......Page 288
Dealing with other problems that impede progress in treatment......Page 289
Index......Page 290