Research showed that more than 30% of patients with Posttraumatic Stress Disorder (PTSD) do not benefit from evidence- based treatments: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Eye Movement Desensitization and Reprocessing (EMDR). These are patients with prolonged and multiple traumatization, with poor verbal memory, and patients with emotional over-modulation. Retelling traumatic experiences in detail is poorly tolerated by these patients and might be a reason for not starting or not completing the recommended treatments. Due to lack of evidence, no alternative treatments are recommended yet. Art therapy may offer an alternative and suitable treatment, because the nonverbal and experiential character of art therapy appears to be an appropriate approach to the often wordless and visual nature of traumatic memories. The objective of this pilot study was to test the acceptability, feasibility, and applicability of trauma-focused art therapy for adults with PTSD due to multiple and prolonged traumatization (patients with early childhood traumatization and refugees from different cultures). Another objective was to identify the preliminary effectiveness of art therapy. Results showed willingness to participate and adherence to treatment of patients. Therapists considered trauma-focused art therapy feasible and applicable and patients reported beneficial effects, such as more relaxation, externalization of memories and emotions into artwork, less intrusive thoughts of traumatic experiences and more confidence in the future. The preliminary findings on PTSD symptom severity showed a decrease of symptoms in some participants, and an increase of symptoms in other participants. Further research into the effectiveness of art therapy and PTSD is needed.
BACKGROUND: Many intensive care unit survivors (ICU) are confronted with undesirable and long-lasting impairments in physical, cognitive, and mental health, but not only patients are at risk of developing this post-intensive care syndrome (PICS). Family members can experience symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). This cluster of complications is called PICS-family.OBJECTIVE: To describe the level of caregiver strain and posttraumatic stress-related symptoms in relatives of ICU survivors.METHODS: We conducted a cohort study in a general hospital between July 2010 and May 2014. Relatives of ICU survivors, mechanically ventilated for > 48 h in the ICU, were asked to complete a questionnaire 3 months after discharge from critical care. Symptoms of PTSD and caregiving concerns were assessed using the Trauma Screening Questionnaire and the Caregiver Strain Index (CSI).RESULTS: A total of 94 relatives visiting our post-ICU clinic completed the questionnaires. Twenty-one percent of the caregivers had a CSI score of 7 or more, indicating high levels of strain. Six percent had CSI scores indicating severe strain (CSI > 10). PTSD-related symptoms were seen in 21% of the caregivers. The mean time spent on caregiving was 10 h (interquartile range 6-17 h) per week.CONCLUSION: This study shows that relatives of ICU survivors could experience strain 3 months after hospital discharge and are at risk of developing PTSD-related symptoms. This complements existing data that relatives are at risk of psychological symptoms. Knowledge can lead to improvements and means to prevent these symptoms. (PsycINFO Database Record
"A proportion of those with eating disorders have also experienced traumatic events and ongoing symptoms of PTSD such as re-experiencing of the trauma and nightmares. We implemented an innovative trauma intervention called Imagery Rescripting (ImRs) to explore whether for those undergoing inpatient treatment for an eating disorder (in an underweight phase), it would be possible to treat the various trauma-related symptoms as well as the eating problems. Since this has not been investigated before, we asked the participants in this study to recount their experiences. Twelve participants who were underweight, reported a past history of trauma and were in an inpatient eating disordertreatment program participated in ImRs therapy intervention. One of these participant did not engage in the ImRs therapy because she discontinued the inpatient ED treatment. Analysis of interviews with these participants found that -although they were reluctant before the start of the treatment- the ImRs treatment during their inpatient admission had given them hope again. They added that it was important to have support from group members, sociotherapists and therapists. They shared a number of ways that the ImRs treatment could be adapted to people with eating disorders. Their experiences indicated that given these factors it was possible to treat PTSD during an underweight phase. This is important: until now, treatment for eating disorders has not specifically been trauma-focused and these tips have scope to improve the ImRs intervention and eating disorder treatment more broadly in the future."
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