Electronic Letters to:

Articles:
Gwen Adshead and Scott Ferris
Treatment of victims of trauma
Adv Psychiatr Treat 2007; 13: 358-368 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read eLetter] Treatment of the Victims of Trauma
Daniel M Beales   (11 October 2007)

Treatment of the Victims of Trauma 11 October 2007
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Daniel M Beales,
Specialist Registrar in Forensic Psychotherapy
The Edenfield Center, Bolton, Salford, Trafford Mental Health NHS Trust

Send letter to journal:
Re: Treatment of the Victims of Trauma

Daniel.Beales{at}bstmht.nhs.uk Daniel M Beales

Adshead and Ferris (2007) in their review of the issues around the treatment of victims of trauma emphasise how cognitive-behavioural approaches have become established as the core to treatment. They quote recent NICE guidelines (2005) to support this but are also clear that there are other models available for complex presentations of trauma related pathology. It is unfortunate that NICE guidelines do not address the issues of the significant proportion of patients who discontinue treatment (which can average over 20%), or fail to respond. Cognitive- behavioural approaches to the treatment of victims of trauma continue to develop, with Wells and Sembi’s metacognitive approach (2004) in particular seeking to address these issues.

The development of cognitive-behavioural approaches which are not based primarily on exposure but on addressing an individual’s difficulties in processing their response to trauma suggests there is room for ongoing developments that would allow rapprochements between different theoretical and therapeutic models; and also potentially inform stepped-care approaches (Bower and Gilbody, 2005). This could support the appropriate matching of patient need and complexity with service and intervention.

Adshead G and Ferris S (2007) Treatment of victims of trauma. Advances in Psychiatric Treatment; 13: 358-368. Bower P and Gilbody S (2005) Stepped care in psychological therapies: access, effectiveness and efficiency. British Journal of Psychiatry; 186: 11-17. Wells, A, and Sembi, S (2004) Metacognitive Therapy for PTSD: A core treatment manual. Cognitive and Behavioral Practice; 11: 365-377. National Collaborating Centre for Mental Health (2005) Post-traumatic stress Disorder: The management of PTSD in adults and children in primary and secondary care. National Clinical Practice Guideline Number 26 (commissioned by the National Institute for Clinical Excellence).