Cognitive behaviour therapy for postnatal post-traumatic stress disorder: Case studies

Department of Psychology, University of Sussex, Falmer, Sussex, UK.
Journal of Psychosomatic Obstetrics & Gynecology (Impact Factor: 1.88). 10/2007; 28(3):177-84. DOI: 10.1080/01674820601142957
Source: PubMed


Background. Approximately 1-2% of women suffer from postnatal post-traumatic stress disorder (PTSD) with wide ranging consequences for these women and their families 1. Appropriate treatment of women who have difficult or traumatic births is not yet established. Evidence in other populations shows that cognitive behavior therapy (CBT) is effective for PTSD and it is therefore the recommended treatment 2. However, a recent review of treatments for postnatal distress concluded that descriptions of postnatal counseling are largely generalized and non-specific, which makes them difficult to assess or replicate 3. Aims and method. The current paper therefore aims to describe the use of CBT interventions to treat postnatal distress, and to illustrate common themes or issues that occur in postnatal PTSD. This paper reports two case studies of women with postnatal PTSD and their treatment using CBT. Conclusions. In these cases, CBT was an effective treatment for postnatal PTSD. A number of implications are explored for the management of pregnancy and labor.

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Available from: Susan Ayers, Mar 25, 2015
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    • "The findings of this review and the in-depth critical appraisal of Ayers et al.'s (2007) paper, all together, show that the studies were able to establish four main themes of PTSD from women who have experienced traumatic childbirth, which fits neatly into the CBT model of PTSD (Elhers and Clark 2000). The findings indicate that women who have gone through traumatic childbirth experience the same PTSD symptoms and those of PTSD of other traumatic events. "
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    ABSTRACT: This paper critically analyses nine studies on postna-tal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive be-havioural therapy (CBT) for postnatal PTSD. This paper found that women following traumatic childbirth do experience post-natal PTSD; postnatal PTSD symptoms are similar to PTSD symptoms of other events and that CBT for PTSD of other events is just as effective for postnatal PTSD. Future recommendations include more qualitative studies with interpretative phe-nomenological approach in order to establish evidence-based CBT treatment for this client group, and more referrals need to be sent to the psychological services for CBT intervention.
    Archives of Women s Mental Health 08/2015; 18(6). DOI:10.1007/s00737-015-0560-x · 2.16 Impact Factor
    • "A further paper (Ayers et al., 2007), describing two case studies, investigated the effect of CBT on PTSD after childbirth. Treatment involved reliving, exposure and cognitive re-appraisal. "
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    ABSTRACT: to systematically identify interventions that midwives could introduce to address post-traumatic stress in women following childbirth. a search strategy was developed and relevant papers were identified from databases including Cinahl, Cochrane Library, EMBASE, Maternity and Infant Care, MEDLINE, PsycINFO, and Web of Science. Key search terms used were post-traumatic stress, post partum, intervention, controlled trial and review. Papers eligible for inclusion were primary studies and reviews of research published from 2002-2012, focusing on interventions which could be implemented by midwives for the prevention and/or management of PTSD. For primary studies, RCTs, controlled clinical trials, and cohort studies with a control group were eligible. Eligible reviews were those with a specified search strategy and inclusion/exclusion criteria. Methodological quality was assessed using recognised frameworks. six primary studies and eight reviews were eligible for inclusion. The majority of included studies or reviews focused on debriefing and/or counselling interventions; however the results were not consistent due to significant variation in methodological quality and use of dissimilar interventions. Two of the reviews considered the general management of post partum PTSD and one broadly covered anxiety during pregnancy and the post partum, incorporating a section on PTSD. The majority of women reported that the opportunity to discuss their childbirth experience was subjectively beneficial. no evidence-based midwifery interventions were identified from this systematic review that can be recommended for introduction into practice to address PTSD. It is recommended that future research in this area should incorporate standardised interventions with similar outcome measures to facilitate synthesis of results. Further research on interventions used in non-maternity populations is needed in order to confirm their usefulness in addressing post partum PTSD.
    Midwifery 09/2013; 30(2). DOI:10.1016/j.midw.2013.09.003 · 1.57 Impact Factor
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    • "Approximately 1%–2% of women suffer from postnatal PTSD, with wide-ranging consequences for themselves and their families. CBT has been reported to be effective in postnatal PTSD.61 However, there is limited evidence concerning the management of women with PTSD after childbirth. "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD. Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites. The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT. There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action.
    Neuropsychiatric Disease and Treatment 04/2011; 7(1):167-81. DOI:10.2147/NDT.S10389 · 1.74 Impact Factor
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