Open Trial of Trauma-Focused Psychodynamic Psychotherapy for Posttraumatic Stress Disorder Among LGBTQ Individuals.

IF 2.3 Q2 PSYCHOLOGY, CLINICAL

AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2023-09-01 DOI:10.1176/appi.psychotherapy.20220037

John R Keefe, Charalambia Louka, Andrew Moreno, Jessica Spellun, Jess Zonana, Barbara L Milrod

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引用次数: 1

Abstract

Objective: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals report higher rates of exposure to traumatic events and posttraumatic stress disorder (PTSD) compared with heterosexual and cisgender individuals. No treatment outcomes research has focused on PTSD in the LGBTQ population. Trauma-focused psychodynamic psychotherapy (TFPP) is a brief, manualized, attachment- and affect-focused psychotherapy for PTSD. TFPP explicitly incorporates broad identity-related and societal factors into its conceptualization of trauma and its consequences, which may be especially helpful for LGBTQ patients with minority stress who seek affirmative care.

Methods: Fourteen LGBTQ patients with PTSD, assessed with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), received 24 sessions of twice-weekly (12 weeks) TFPP via teletherapy provided by supervised early-career therapists inexperienced in the modality. Sessions were videotaped to monitor therapists' treatment adherence. Patients were assessed at baseline, week 5, termination (week 12), and 3 months posttreatment for PTSD symptoms (assessed with the CAPS-5) and secondary outcomes.

Results: TFPP was well tolerated by patients, with 12 (86%) completing the intervention. CAPS-5-measured PTSD symptoms, including dissociation, significantly improved during treatment (mean decrease=-21.8, d=-1.98), and treatment gains were maintained at follow-up. Most patients experienced PTSD clinical response (N=10, 71%) or diagnostic remission (N=7, 50%). Patients generally experienced significant, concomitant improvements in complex PTSD symptoms, general anxiety, depression, and psychosocial functioning. Adherence to the intervention among therapists was high, with 93% of rated sessions meeting adherence standards.

Conclusions: TFPP shows promise in the treatment of PTSD among sexual and gender minority patients seeking LGBTQ-affirmative PTSD care.

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LGBTQ创伤后应激障碍创伤关注心理动力心理治疗的公开试验

目的:女同性恋、男同性恋、双性恋、跨性别和酷儿(LGBTQ)个体报告的创伤性事件和创伤后应激障碍(PTSD)的暴露率高于异性恋和异性恋个体。目前还没有针对LGBTQ人群PTSD的治疗结果研究。以创伤为中心的心理动力治疗(TFPP)是一种简短的、手动的、以依恋和情感为中心的创伤后应激障碍心理治疗。TFPP明确地将广泛的身份相关因素和社会因素纳入其创伤及其后果的概念化中，这可能对寻求积极护理的少数族裔压力的LGBTQ患者特别有帮助。方法:14名LGBTQ PTSD患者，采用DSM-5临床应用PTSD量表(CAPS-5)进行评估，通过远程治疗接受24次，每周两次(12周)的TFPP治疗，由没有经验的早期职业治疗师提供远程治疗。治疗过程被录下来，以监控治疗师的治疗依从性。在基线、第5周、终止治疗(第12周)和治疗后3个月评估患者的PTSD症状(用CAPS-5评估)和次要结局。结果:患者对TFPP耐受良好，12例(86%)患者完成了干预。caps -5测量的PTSD症状，包括分离，在治疗期间显著改善(平均减少=-21.8,d=-1.98)，并且在随访中保持治疗效果。大多数患者出现PTSD临床反应(N=10, 71%)或诊断缓解(N=7, 50%)。患者通常在复杂的PTSD症状、一般焦虑、抑郁和社会心理功能方面有显著的改善。治疗师对干预的依从性很高，93%的评估疗程达到了依从性标准。结论:TFPP在寻求LGBTQ-affirmative PTSD护理的性少数和性别少数患者中显示出治疗PTSD的希望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AMERICAN JOURNAL OF PSYCHOTHERAPY PSYCHOLOGY, CLINICAL-

CiteScore

2.90

自引率

4.00%

发文量

期刊介绍： Founded in 1939, the American Journal of Psychotherapy (AJP) has long been a leader in the publication of eclectic articles for all psychotherapists. Transtheoretic in reach (offering information for psychotherapists across all theoretical foundations), the goal of AJP is to present an overview of the psychotherapies, subsuming a host of schools, techniques, and psychological modalities within the larger domain of clinical practice under broad themes including dynamic, behavioral, spiritual, and experiential.