Printer Friendly

20% dropout rate hinders prolonged therapy. (Intense Therapeutic Experience).

BALTIMORE - The ideal early treatment for acute stress disorder in recent trauma survivors may prove to be a "hot" cognitive therapy that combines the best of cognitive therapy with the best of prolonged exposure therapy.

Of the two treatments, prolonged exposure therapy is more effective in treating acute stress disorder, but 20% of patients find the therapeutic experience so intense that they cannot finish treatment, Richard Bryant, Ph.D., said at the annual meeting of the International Society for Traumatic Stress Studies.

In addition, another 20% of patients do not respond to this therapy within 6 months. That means that at least 40% of people with acute stress disorder are not getting the help they need, he said.

"We need to develop interventions that most people can benefit from," Dr. Bryant said. In his proposed "hot" cognitive therapy, a patient does exposure-type exercises to boost emotional processing without actual in vivo exposure to traumatic stimuli.

"It combines the best from each therapy," said Dr. Bryant, director of clinical psychology at the University of New South Wales in Sydney, Australia.

Dr. Bryant reported on an ongoing study of 40 survivors of nonsexual assault who had developed acute stress disorder and were at risk for posttraumatic stress disorder. They were randomized to prolonged exposure therapy using imagined exposure to traumatic stimuli, cognitive therapy without exposure, and supportive counseling. As expected, more patients are dropping out of prolonged exposure therapy than are dropping out of cognitive therapy or supportive counseling.

"We know that prolonged exposure therapy is more effective than cognitive therapy, but we lose too many people," Dr. Bryant said.

For some, early intervention with cognitive behavioral therapy has the ability to avert the progression of acute distress syndrome to posttraumatic stress disorder.

Treatment is not necessary for most people exposed to a traumatizing event. "Most people are resilient. They'll have a transient stress reaction" and then move on with their lives, Dr. Bryant said.

An estimated 80% of people who develop acute stress disorder after a traumatic event will progress to posttraumatic stress disorder unless they receive treatment. "There is little chance that they will get better without our help," said Dr. Bryant, who added that 70% of people with untreated posttraumatic stress disorder still have it 2 years after diagnosis.

Treatment should be reserved for people who meet the criteria for acute stress disorder that are listed in the DSM-IV In general, patients with acute stress disorder experience dissociation, re-experience, avoidance, and arousal within the first month after the traumatic event.
COPYRIGHT 2003 International Medical News Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2003 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Kubetin, Sally Koch
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Jan 1, 2003
Words:421
Previous Article:New Depakote warning. (FYI).
Next Article:Therapy cuts alcohol intake, slows fibrosis. (Reduction, not Abstinence).
Topics:


Related Articles
Brief CBT Improves Insight in Schizophrenia.
PTSD responds to Mix to Drugs, Psychotherapy. (Consider CBT, SSRI).
Integration strategy strengthens eating disorder tx. (Psychodynamic, Behavioral Approaches).
Treat PTSD and comorbid substance abuse for best results. (Patients Want to Talk About Traumas).
Understanding dropouts. .
Trauma Tx for Vietnam veterans. (Clinical Capsules).
Prolonged exposure therapy lessens PTSD symptoms.
Placing short-term psychotherapy first.
Prolonged exposure therapy works in community settings.
Complete recovery now possible for patients with 'untreatable' mental illness.

Terms of use | Privacy policy | Copyright © 2020 Farlex, Inc. | Feedback | For webmasters