Behavioural and Cognitive Psychotherapy

Behavioural and Cognitive Psychotherapy / Volume 44 / Issue 04 / July 2016, pp 385-396

Copyright British Association for Behavioural and Cognitive Psychotherapies 2015

DOI: http://dx.doi.org/10.1017/S1352465815000685 (About DOI), Published online: 05 November 2015

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Empirically Grounded Clinical Interventions

The Maintaining Factors of Social Anxiety: A Three-Group Comparison
of a Clinical Sample with Highly Socially Anxious Students and NonAnxious Students
Sonja Skocica1 c1, Henry Jacksona1, Carol Hulberta1 and Christina Fabera1
a1

The University of Melbourne, Australia

Abstract

Background: Clark and Wells' (1995) cognitive model of social anxiety (CWM) explains the maintenance of social anxiety and has
been used as a guide for treatment of Social Anxiety Disorder (SAD). Few studies have examined the components of the model
together across different samples. Aims: This study had two distinct aims: to test the components of CWM and to examine how the
variables of CWM may differ between clinical and non-clinical samples with varying levels of social anxiety. Method: Hypothesized
relationships between three groups (i.e. a clinical sample of individuals diagnosed with SAD (ClinS), n = 40; socially anxious students
(HSA), n = 40; and, non-anxious students (LSA), n = 40) were investigated. Results: Four out of five CWM variables tested were
able to distinguish between highly socially anxious and non-anxious groups after controlling for age and
depression. Conclusions:CWM variables are able to distinguish between high and low levels of social anxiety and are uniquely
related to social anxiety over depression.
(Online publication November 05 2015)

Behavioural and Cognitive Psychotherapy

Behavioural and Cognitive Psychotherapy / Volume 44 / Issue 04 / July 2016, pp 420-430

Copyright British Association for Behavioural and Cognitive Psychotherapies 2015

DOI: http://dx.doi.org/10.1017/S1352465815000338 (About DOI), Published online: 20 July 2015

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Clients' Experiences of Returning to the Trauma Site during PTSD

Treatment: An Exploratory Study
Hannah Murraya1 c1, Chris Merritta2 and Nick Greya3
Traumatic Stress Service, South-West London and St Georges NHS Trust, UK
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
a3
Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, UK
a1
a2

Abstract
Background: Visits to the location of the trauma are often included in trauma-focused cognitive behavioural therapy (TF-CBT) for
post-traumatic stress disorder (PTSD), but no research to date has explored how service users experience these visits, or whether
and how they form an effective part of treatment. Aims: The study aimed to ascertain whether participants found site visits helpful,
to test whether the functions of the site visit predicted by cognitive theories of PTSD were endorsed, and to create a grounded
theory model of how site visits are experienced. Method: Feedback was collected from 25 participants who had revisited the scene
of the trauma as part of TF-CBT for PTSD. The questionnaire included both free text items, for qualitative analysis, and forced-choice
questions regarding hypothesized functions of the site visit. Results: Overall, participants found the site visits helpful, and endorsed
the functions predicted by the cognitive model. A model derived from the feedback illustrated four main processes occurring during
the site visit: facing and overcoming fear; filling in the gaps; learning from experiences and different look and feel to the
site, which, when conducted with help and support, usually from the therapist, led to a sense of closure and moving
on. Conclusions: Therapist-accompanied site visits may have various useful therapeutic functions and participants experience
them positively.
(Online publication July 20 2015)

Keywords:

Post-traumatic stress disorder;

PTSD;
CBT;
cognitive therapy;
trauma

Correspondence

Reprint requests to Hannah Murray, South-West London and St Georges NHS Trust, Traumatic Stress Service, Building 2, Springfield
Hospital, Glenburnie Road, London SW17 7DJ, UK. E-mail: hannah.murray@swlstg-tr.nhs.uk
c1

EPISODE 49: TRAUMA TREATMENTS

Written by admin on Thursday, May 7, 2015
On this show Dr. Gloria Horsley and Dr. Heidi Horsley discuss with Dr. Bessel Van der Kolk author of The Body
Keeps the Score: Brain, Mind, and Body in the Healing of Trauma EMDR and Neurofeedback for repairing
faulty connections and connectivity patterns. Dr. David Fajgenbaum joins the group to discuss how the death of
his mother, while he was a college student, inspired him to found the National Students of AMF Support
Network an organization helping grieving students.

http://www.opentohope.com/episode-49-trauma-treatments/
Doliul psihologic apare in cadrul unei situatii semnificative de viata, decesul. In functie de istoria de viata si de
acntecedentele personale, perioada si intensitatea doliului psihologic sunt diferite de la o persoana la alta.
Participarea directa la ritualurile inmormantarii si manifestarea libera a suferintei provocate de respectivul deces, pot
favoriza inchiderea respectivului doliu.

Doliul psihologic un episod depresiv major

Persoanele care trec printr-un doliu psihologic au de parcurs o serie de etape.

Prima etapa este reprezentata de negare. Acum poate aparea blocajul emotional, cand persoana respectiva nu poate
intelege si nu realizeaza cele intamplate.
Negarea se manifesta prin:

deziluzie;
negarea semnificatiei pierderii;
uitarea selectiva.
O alta etapa se refera la starile confuzionale, cand se incearca gasirea unor explicatii rationale sau spirituale fata de cele
intamplate.
Pentru ca procesul de doliu psihologic sa aiba un traiect normal, persoana aflata in aceasta situatietrebuie sa accepte
realitatea pierderii si sa o inteleaga la nivel emotional si intelectual. Acestea ajuta la relocarea emotionala a
decedatului, sustragerea energiei emotionale investita in decedat si reinvestirea ei in alte relatii. Se pot dezvolta anumite
legaturi continue cu decedatul, gasindu-se un nou loc decedatului care sa faciliteze conectarea cu el (aparitia in vis celui
decedat).
In functie de situatiile de viata, istoria si antecedentele personale, trecerea printr-o astfel de situatie poate predispune la
tulburari depresive. Vorbim aici de cazurile in care se produce decesul unei fiinte dragi, semnificative pentru persoana in
cauza. In aceasta situatie, participarea activa la ritualurile inmormantarii, la ritualurile de dupa imormantare si
suportul emotional din partea familiei si celor apropiati, ajuta la intelegerea si depasirea starii de doliu.

Cand ceri sfatul specialistului?

Daca sunt manifeste mai multe din descrierile de mai jos, este indicat sa apelezi la sprijinul unui specialist:

Persoana nu poate vorbi despre decedat fara a manifesta un doliu intens (plans in crize etc).
Persoana care a trecut printr-un doliu nu poate sa se desprinda de lucrurile persoanei decedate.
De multe ori cel care este in doliu manifesta simptome fizice ca ale decedatului.
Apare tendinta de a se izola si luarea de decizii drastice negative de a-si schimba radical viata.
Tulburari depresive majore, culpabilitate persistenta si o stima de sine scazuta; impulsuri auto-distructive, imitarea
compulsiva a persoanei decedate, tristete intensa care apare in aceeasi perioada a anului, fobie legata de moarte sau de
imbolnavire.

Ce metode folosim pentru depasirea doliului?

folosirea simbolurilor: fotografii, scrisori care sa evoce persoana pierduta si sa readuca; in prim plan amintirea

momentelor placute;
scrisul: scrisori pentru decedat in care se exprima ceea ce se simte ca o incheiere a relatiei si o metoda de a

exterioriza corect durerea coplesitoare;

desenul: exprimarea grafica a sentimentelor, folosirea metaforelor.
In concluzie, problematica doliului se manifesta diferit de la o persoana la alta iar gravitatea acesteia depinde de o multime
de factori. Totusi, de multe ori tindem sa intelegem gresit comportamentele exagerate ale unei persoane indoliate si sa le
punem pe seama legaturii dintre ea si persoana decedata sau pe seama firescului, normalului.
Incurajarea si intelegerea acordate in asemenea situatii sunt doar un suport incipient si benefic atunci cand este dublat de
impulsuri optimiste si actiuni de sustinere a schimbarii unui comportament. Daca acestea nu dau rezultate, nu asteptati mult
timp pana sa apelati la sfaturile unui specialist.