TRAUMA FOCUS GROUP-THERAPY FOR COMBAT-RELATED PTSD

Although individual therapy involving imaginal experiencing of the tra umatic event has been found to be effective in treating PTSD, there is evidence that few trauma therapists actually use the technique. Moreo ver, symptom improvement has been found to favor intrusive symptoms, w hereas avoidance and hyperarousal have been less affected. Additionall y, there are several published reports documenting difficulties in imp lementing the treatment, ranging from client refusal, adverse reaction s, and therapist inexperience. In this article we outline an alternati ve group form of exposure therapy, manualized trauma focus group thera py (TFGT), designed to overcome some of these implementation obstacles and to enhance the effects of imaginal exposure to include those chro nic PTSD symptoms of avoidance and social isolation. We describe the c ognitive behavioral and developmental models from which the approach w as derived, present clinical guidelines and an illustrative session, d iscuss complications we have encountered in TFGT pilot studies, and of fer suggestions for improving future implementation. (C) 1997 John Wil ey & Sons, Inc.