Patient perspectives on the effectiveness and tolerability of group-based exposure therapy for posttraumatic stress disorder: Preliminary self-report findings from 20 veterans

摘要

Although an extensive body of empirical literature supports the efficacy of individual exposure therapy for posttraumatic stress disorder (PTSD), there is substantial debate about the suitability of exposure-based techniques in group treatment settings. Whereas some clinicians and researchers have predicted that these techniques may vicariously traumatize patients, others have argued that the group setting may facilitate exposure work by offering opportunities for normalization and social support. Few studies, however, have explored patients' opinions on group exposure. This study examined veterans' perspectives on the effectiveness and tolerability of a 12-week model of group-based exposure therapy (GBET) for PTSD. Analysis of qualitative and quantitative self-report data from 20 combat veterans indicated that participants were highly satisfied with GBET and experienced it as both helpful and acceptable. Eighty-five percent of the sample (n = 16) evidenced reliable reductions in PTSD symptoms from pre- to posttreatment, without experiencing symptom exacerbation over the course of treatment. The observed dropout rate was low (5%, n = 1), and treatment completers reported that commitment to the group was instrumental in their decision to remain in treatment. Veterans described that hearing other group members' in-session imaginal exposures had a normalizing effect, and they indicated that feedback from fellow veterans on their own imaginal exposures was the most helpful aspect of GBET.