Control-Focused Behavioral Treatment: A brief intervention for survivors of war and torture
DOI:
https://doi.org/10.7146/torture.v32i1-2.131322Palabras clave:
trauma, torture, behavioral treatmentResumen
This article briefly reviews the evolution and evidence-base of Control-Focused Behavioral Treatment (CFBT), largely self-helpbased treatment that involves no cognitive interventions, focuses solely on reducing avoidance behaviors through self-exposure to anxiety-evoking trauma cues, and, unlike other interventions, aims to enhance sense of control over traumatic stressors, rather than anxiety reduction. As such, it is radically
different from other interventions in both theory and practice. Our studies have shown improvement rates of 80%-85% with a single treatment session in earthquake survivors. When administered in an average of 6 sessions in war and torture survivors, it achieved 82% reduction in posttraumatic stress symptoms (PTSD), leaving 97% of the cases nearly asymptomatic or with only mild PTSD symptoms. Meta-analytical comparisons suggest that such improvement rates are substantially higher than those achieved by
other evidence-based treatments.
Citas
Başoğlu, M. (2006) Rehabilitation of traumatised refugees and survivors of torture – After almost two decades we still do not use evidence-based treatments. British Medical Journal, 333, 1230-1231. 10.1136/bmj.39036.739236.43
Başoğlu, M. & Aker, T. (1996) Cognitive-behavioural treatment of torture survivors: A case study. Torture, 6, 61-65.
Başoğlu, M., Ekblad, S., Bäärnhielm, S., & Livanou, M. (2004) Cognitive-behavioral treatment of tortured asylum seekers: A case study. Journal of Anxiety Disorders, 18 (3), 357-369. https://doi.org/10.1016/S0887-6185(02)00248-7
Başoğlu M., & Marks, I. M. (1988) Torture. Research needed into how to help those who have been tortured. British Medical Journal, 297, 1423-4.
Başoğlu, M.., Livanou, M., & Şalcıoğlu, E. (2003) A single session with an earthquake simulator for traumatic stress in earthquake survivors. American Journal of Psychiatry, 160, 788–790. https://doi.org/10.1176/ajp.160.4.788
Başoğlu, M., Livanou, M., Şalcıoğlu, E., & Kalender, D. (2003) A brief behavioural treatment of chronic posttraumatic stress disorder in earthquake survivors: Results from an open clinical trial. Psychological Medicine, 33, 647–654. 10.1017/s0033291703007360
Başoğlu, M., & Mineka, S. (1992) The role of uncontrollability and unpredictability of stress in the development of post-torture stress symptoms. In M. Başoğlu (Ed.), Torture and its consequences: Current treatment approaches (182-225). Cambridge: Cambridge University Press.
Başoğlu, M., & Şalcıoğlu, E. (2011). A mental healthcare model for mass trauma survivors: Control-Focused Behavioral Treatment of earthquake, war, and torture trauma. Cambridge: Cambridge University Press.
Başoğlu, M., Şalcıoğlu, E., & Livanou, M. (2007) A randomized controlled study of single-session behavioural treatment of earthquake-related posttraumatic stress disorder using an earthquake simulator. Psychological Medicine, 37, 203–213. https://doi.org/10.1017/S0033291706009123
Başoğlu, M., Şalcıoğlu, E., & Livanou, M. (2009) Single-case experimental studies of a self-help manual for traumatic stress in earthquake survivors. Journal of Behaviour Therapy and Experimental Psychiatry, 40, 50-58. https://doi.org/10.1016/j.jbtep.2008.04.001
Başoğlu, M., Şalcıoğlu, E., Livanou, M., Kalender, D., & Acar, G. (2005) Single-session behavioral treatment of earthquake-related posttraumatic stress disorder: A randomized waiting list controlled trial. Journal of Traumatic Stress, 18, 1–11. https://doi.org/10.1002/jts.20011
Beck, A. T., Rial, W. Y., & Rickels, R. (1974) Short form of depression inventory: cross validation. Psychological Reports, 34, 1184 –1186. https://doi.org/10.1177/003329417403403s01
Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Charney, D. S., & Keane, T. M. (1990) Clinician-Administered PTSD Scale (CAPS) – Current and Lifetime Diagnostic Version. Boston: National Center for Posttraumatic Stress Disorder, Behavioral Science Division.
Boyd, J .E., Lanius, R.A., & McKinnon, M. C. (2108) Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience, 43 (1), 7–25. https://doi.org/10.1503/jpn.170021
Bradley, R., Greene, J., Russ, E., Dutra, L. & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214-227. https://doi.org/10.1176/appi.ajp.162.2.214
British Medical Journal (2006) Rapid responses. https://www.bmj.com/content/333/7581/1230/rapid-responses. Accessed October 27, 2021.
Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016) Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128-41. https://doi.org/10.1016/j.cpr.2015.10.003
Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A. & Street, G. P. (1999) A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67, 194–200. 10.1037//0022-006x.67.2.194
Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A. M., Riggs, D. S., Feeny, N. C, & Yadin, E. (2005) Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73, 953–964. https://doi.org/10.1037/0022-006X.73.5.953
Foa, E. B., Rothbaum, B. O., Riggs, D. S. & Murdock, T. (1991) Treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive-behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715–723. https://doi.org/10.1037/0022-006X.59.5.715
Hansen, A. K. V., Hansen-Nord, N. S., Smeir, I., Engelkes-Heby, L., & Modvig J. (2017) Impact of Narrative Exposure Therapy on torture survivors in the MENA region. Torture, 27 (3), 49-63. https://doi.org/10.7146/torture.v27i3.103977
Jaranson, J. M. (2007) Standard therapy for all torture survivors: A reply to Metin Basoglu. British Medical Journal. https://www.bmj.com/rapid-response/2011/11/01/standard-therapy-all-torture-survivors-reply-metin-basoglu. Last accessed October 27, 2021).
Marks, I. M., Lovell, K., Noshirvani, H., & Livanou, M. (1998). Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring - A controlled study. Archives of General Psychiatry, 55, 317-325. 10.1001/archpsyc.55.4.317
Mineka, S. & Zinbarg, R. (2006). A contemporary learning theory perspective on the etiology of anxiety disorders – It is not what you thought it was. American Psychologist, 61, 10-26. 10.1037/0003-066X.61.1.10
Paunovic, N., & Öst, L. G. (2001). Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees. Behaviour Research and Therapy, 39, 1183-1197. 10.1016/s0005-7967(00)00093-0
Stenmark, H., Catani, C., Neuner, F., Elbert, T., & Holen, A. (2013) Treating PTSD in refugees and asylum seekers within the general health care system. A randomized controlled multicenter study. Behaviour Research and Therapy, 51(10), 641-647. 10.1016/j.brat.2013.07.002
Turrini, G., Purgato, M., Acarturk, M., Anttila, M., Au, T., Ballette, F., …Barbui, C. (2019) Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis. Epidemiology and Psychiatric Sciences, 28(4), 376-388. https://doi.org/10.1017/S2045796019000027
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