Advances in the Treatment of Posttraumatic Stress Disorder: Cognitive-Behavioral Perspectives

By Steven Taylor | Go to book overview

Chapter 13
COGNITIVE-BEHAVIORAL
INTERVENTIONS FOR CHILDREN
AND ADOLESCENTS WITH PTSD

Philip A. Saigh, Maria R. Brassard, and Stephen T. Peverely


HISTORICAL BACKGROUND

Historically, different forms of exposure-based anxiety-reduction procedures have been used for hundreds of years (Saigh, 2002; Saigh, Yasik, Oberfield, & Inamder, 1999). Goethe's autobiography presents a graphic account of his self-induced treatment of acrophobia (Boudewyns & Shipley, 1983). More recently, Malleson (1959) described a course of imaginai or in vitro exposure that was used to reduce distress of a test-phobic graduate student. The student was described as [classically panic stricken… sobbing and fearful, bewailing his fate, and terrified of the impending examination] (p. 225). In lieu of prescribing the standard treatment of that era (i.e., psychoanalysis), Malleson asked the student to [tell of the awful consequences that he felt would follow his failure—derision from his colleagues … disappointment from his family and financial loss] (p. 225). The student was also instructed that when he [felt a little wave of spontaneous alarm, he was not to push it aside, but was to augment it, to try to experience it more profoundly and more vividly] (p. 225). Although the regimen was associated with a degree of distress, the patient adhered to Malleson's instructions and reported that he was almost unable to experience test-related anxiety as the date of the examination approached. As it were, he passed the exam with ease.

In 1961 Stampfl coined the term [implosive therapy] to describe a treatment that [may be regarded as a synthesis between Freudian oriented

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