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In Reply to: Is this a serious new direction? posted by Observer on February 20, 2006 at 14:41:47:
There is a variant of cognitive/behavioral therapy that is specifically for people with trauma issues. It's called Trauma-Focused CBT or TF-CBT.
For people with childhood abuse issues, it's important to acknowledge what happened, but it's not necessary to revisit the traumatic events and remember what occurred in great detail. TF-CBT helps an individual identify the cognitive distortions or faulty assumptions that are a consequence of the abuse.
Children who grow up with various forms of maltreatment will develop coping strategies based on the need to socially adapt, even though the situation to which they attempt adaptation is dysfunctional. The coping strategies that serve the child growing up in an abusive environment don't serve the grown adult so well, particularly if s/he wants to change self-destructive and self-defeating behavior patterns.
The focus of CBT is how to change self-destructive behaviors & self-defeating attitudes in the here and now. Insight into how these behaviors & attitudes are linked to growing up in an abusive environment may occur during the course of treatment, but research has shown repeatedly that insight into a problem doesn't necessarily result in changed behavior. There are things people can do to change self-defeating behavior & attitudes that require little insight into the root causes of the problem. The individual mainly needs to understand the attitudes & beliefs underlying the problematic behavior and symptoms.
TF-CBT also helps people identify triggers and stressors and develop healthier coping strategies to manage the anxiety. A TF-CBT treatment goal might include increasing the level of physical exercise as a way to better manage anxiety, which is a major symptom of PTSD. A therapy session with this sort of treatment goal might involve identifying distorted perceptions or faulty cognitions that reduce motivation for self-care and physical health maintenance. People with trauma issues often have distorted perceptions and faulty beliefs about their bodies. Obesity is a major physical health issue for adults with major traumatic events in their childhood.
CBT and TF-CBT have undergone a number of clinical trials and have been demonstrated to be effective in reducing symptom distress and increasing social functioning. CBT is considered an evidence-based practice, and it is so effective that people often improve after only 10 sessions or less. Speedy results are usually due to a combination of CBT & pharmaco-therapy; people who choose to forgo medications can also get very good results, but it may take a little longer.
