Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre
ABSTRACTBackground: Recent practice guidelines strongly recommend evidence-based psychotherapies (EBPs) as the first-line treatment for post-traumatic stress disorder (PTSD). However, previous studies found barriers to the implementation of EBPs and a relatively high dropout rate in clinical setting...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2024-12-01
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| Series: | European Journal of Psychotraumatology |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/20008066.2024.2302703 |
| _version_ | 1797347639921999872 |
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| author | Azusa Saito Nobuko Tsuruta Yoko Arai Kaori Okamoto Tomomi Narisawa Mari Nozaki Natsuki Konno Nozomu Asukai |
| author_facet | Azusa Saito Nobuko Tsuruta Yoko Arai Kaori Okamoto Tomomi Narisawa Mari Nozaki Natsuki Konno Nozomu Asukai |
| author_sort | Azusa Saito |
| collection | DOAJ |
| description | ABSTRACTBackground: Recent practice guidelines strongly recommend evidence-based psychotherapies (EBPs) as the first-line treatment for post-traumatic stress disorder (PTSD). However, previous studies found barriers to the implementation of EBPs and a relatively high dropout rate in clinical settings. After proving the efficacy of prolonged exposure (PE) in Japan [Asukai, N., Saito, A., Tsuruta, N., Kishimoto, J., & Nishikawa, T. (2010). Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study. Journal of Traumatic Stress, 23(6), 744–750. https://doi.org/10.1002/jts.20589], we began implementing PE in a real-world clinical setting at the Victim Support Center of Tokyo (VSCT).Objective: We aimed to investigate the effectiveness and benefit of PE for crime-induced PTSD among VSCT clients and what causes dropout from treatment.Method: Of 311 adult clients who received counselling from clinical psychologists at VSCT due to violent or physical crime victimization from April 2008 through December 2019, 100 individuals received PE and participated in this study. Their PTSD symptoms were evaluated before and after treatment using the Impact of Event Scale-Revised and the Clinician-Administered PTSD Scale for DSM-IV.Results: A total of 93 participants completed PE and seven dropped out after six sessions or less. The completers group improved in PTSD symptoms with significant score differences between pre- and post-treatment in IES-R and CAPS-IV. Participants’ symptoms did not exacerbate after treatment. Forty of 49 completers who left their workplace or college/school after victimization returned to work or study shortly after treatment. Compared to the completers, all dropout participants were women and younger. The majority were rape survivors, with significantly shorter intervals between victimization and treatment. The reasons for dropout were difficulty scheduling treatment between work/study schedules and manifestation of bipolar disorder or physical illness.Conclusions: PE can be implemented with significant effectiveness and a low dropout rate in a real-world clinical setting if advantages in the system and policies, local organizational context, fidelity support and patient engagement are fortified. |
| first_indexed | 2024-03-08T11:50:43Z |
| format | Article |
| id | doaj.art-bd24931fd083480198372805818c1320 |
| institution | Directory Open Access Journal |
| issn | 2000-8066 |
| language | English |
| last_indexed | 2024-03-08T11:50:43Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj.art-bd24931fd083480198372805818c13202024-01-24T10:51:14ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662024-12-0115110.1080/20008066.2024.2302703Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centreAzusa Saito0Nobuko Tsuruta1Yoko Arai2Kaori Okamoto3Tomomi Narisawa4Mari Nozaki5Natsuki Konno6Nozomu Asukai7Faculty of Human Sciences, Department of Psychology, Sophia University, Tokyo, JapanVictim Support Center of Tokyo, Tokyo, JapanVictim Support Center of Tokyo, Tokyo, JapanVictim Support Center of Tokyo, Tokyo, JapanVictim Support Center of Tokyo, Tokyo, JapanVictim Support Center of Tokyo, Tokyo, JapanVictim Support Center of Tokyo, Tokyo, JapanVictim Support Center of Tokyo, Tokyo, JapanABSTRACTBackground: Recent practice guidelines strongly recommend evidence-based psychotherapies (EBPs) as the first-line treatment for post-traumatic stress disorder (PTSD). However, previous studies found barriers to the implementation of EBPs and a relatively high dropout rate in clinical settings. After proving the efficacy of prolonged exposure (PE) in Japan [Asukai, N., Saito, A., Tsuruta, N., Kishimoto, J., & Nishikawa, T. (2010). Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study. Journal of Traumatic Stress, 23(6), 744–750. https://doi.org/10.1002/jts.20589], we began implementing PE in a real-world clinical setting at the Victim Support Center of Tokyo (VSCT).Objective: We aimed to investigate the effectiveness and benefit of PE for crime-induced PTSD among VSCT clients and what causes dropout from treatment.Method: Of 311 adult clients who received counselling from clinical psychologists at VSCT due to violent or physical crime victimization from April 2008 through December 2019, 100 individuals received PE and participated in this study. Their PTSD symptoms were evaluated before and after treatment using the Impact of Event Scale-Revised and the Clinician-Administered PTSD Scale for DSM-IV.Results: A total of 93 participants completed PE and seven dropped out after six sessions or less. The completers group improved in PTSD symptoms with significant score differences between pre- and post-treatment in IES-R and CAPS-IV. Participants’ symptoms did not exacerbate after treatment. Forty of 49 completers who left their workplace or college/school after victimization returned to work or study shortly after treatment. Compared to the completers, all dropout participants were women and younger. The majority were rape survivors, with significantly shorter intervals between victimization and treatment. The reasons for dropout were difficulty scheduling treatment between work/study schedules and manifestation of bipolar disorder or physical illness.Conclusions: PE can be implemented with significant effectiveness and a low dropout rate in a real-world clinical setting if advantages in the system and policies, local organizational context, fidelity support and patient engagement are fortified.https://www.tandfonline.com/doi/10.1080/20008066.2024.2302703Post-traumatic-stress-disorderevidence-based-psychotherapiesprolonged-exposureimplementationtreatment-dropoutvictim-support |
| spellingShingle | Azusa Saito Nobuko Tsuruta Yoko Arai Kaori Okamoto Tomomi Narisawa Mari Nozaki Natsuki Konno Nozomu Asukai Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre European Journal of Psychotraumatology Post-traumatic-stress-disorder evidence-based-psychotherapies prolonged-exposure implementation treatment-dropout victim-support |
| title | Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre |
| title_full | Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre |
| title_fullStr | Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre |
| title_full_unstemmed | Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre |
| title_short | Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre |
| title_sort | effectiveness of prolonged exposure pe after implementation at a crime victim support centre |
| topic | Post-traumatic-stress-disorder evidence-based-psychotherapies prolonged-exposure implementation treatment-dropout victim-support |
| url | https://www.tandfonline.com/doi/10.1080/20008066.2024.2302703 |
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