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CBT and Research: The evidence base

When individuals experience traumatic events which often happen in a very short space of time e.g. earthquakes, floods, robberies or accidents, or whether events happen over longer periods of time e.g. being caught up in wars or other types of violence or abuse, symptoms such as flashbacks and nightmares occur when faced with reminders of the traumatic experience (e.g. smells, people who look or sound similar to those involved in the event or events). As well as flashbacks and nightmares, there is also sleep disturbance, concentration problems, tendency to become irritable, fatigue, thinking too much (about the index incidents), pains in the neck, feeling under threat, violation of ethics, anxiety and feelings of anger. At times, people who have been a victim of trauma turn to self medication (drug or alcohol) to help them cope. This will not help the victim recover from the trauma if they have experienced the above symptoms. Studies have shown that CBT is a more effective treatment for victims of disaster.

CBT helps people who have experienced trauma by exposing them to trauma cues over a prolonged period of time. This helps to reduce distress and provides control over traumatic stress challenges. Avoidance behaviours are identified and put into a hierarchical order and then individuals are encouraged to expose themselves to feared situations.   

Useful References

Basoglu, M, Ekblad, S, et al (2004) Cognitive Behavioral Treatment for Tortured Asylum Seekers: A case study. Journal of Anxiety Disorders, 18, 357-369.

Briere, J., & Scott, C. (2006). Principles of trauma therapy: A guide to symptoms, evaluations, and treatment. Thousand Oaks, London, New Delhi: Sage Publications.

Ehlers, A., & Clark, D. (2000). A cognitive model of posttraumatic stress disorder. Behavioral Research and Therapy, 38, 319-345.

Hinton, D., Chhean, D., Pich, V., Safren, S., Hoffman, S., & Pollack, M. (2005). A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: A cross-over design. Journal of Traumatic Stress, 18(6), 617-629.

Krakow, B., Johnston, L., Melendrez, D., Hollifield, M., Warner, T., Chavez-Kennedy, Debie., et al. (2001). An open-label trial of evidence-based cognitive behavior therapy for nightmares and insomnia in crime victims with PTSD. American Journal of Psychiatry, 158, 2043-2047.

Krakow, B., Kellner, R., Pathak, D., & Lambert, L. (1995). Imagery rehearsal treatment for chronic nightmares. Behavior Research and Therapy, 33, 837-843.

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