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Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans

Posttraumatic stress disorder (PTSD) is a highly disabling disorder, afflicting African Americans at disproportionately higher rates than the general population. When receiving treatment, African Americans may feel differently towards a European American clinician due to cultural mistrust. Furthermo...

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Autores principales: Williams, Monnica T., Malcoun, Emily, Sawyer, Broderick A., Davis, Darlene M., Bahojb Nouri, Leyla, Bruce, Simone Leavell
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219246/
https://www.ncbi.nlm.nih.gov/pubmed/25379272
http://dx.doi.org/10.3390/bs4020102
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author Williams, Monnica T.
Malcoun, Emily
Sawyer, Broderick A.
Davis, Darlene M.
Bahojb Nouri, Leyla
Bruce, Simone Leavell
author_facet Williams, Monnica T.
Malcoun, Emily
Sawyer, Broderick A.
Davis, Darlene M.
Bahojb Nouri, Leyla
Bruce, Simone Leavell
author_sort Williams, Monnica T.
collection PubMed
description Posttraumatic stress disorder (PTSD) is a highly disabling disorder, afflicting African Americans at disproportionately higher rates than the general population. When receiving treatment, African Americans may feel differently towards a European American clinician due to cultural mistrust. Furthermore, racism and discrimination experienced before or during the traumatic event may compound posttrauma reactions, impacting the severity of symptoms. Failure to adapt treatment approaches to encompass cultural differences and racism-related traumas may decrease treatment success for African American clients. Cognitive behavioral treatment approaches are highly effective, and Prolonged Exposure (PE) in particular has the most empirical support for the treatment of PTSD. This article discusses culturally-informed adaptations of PE that incorporates race-related trauma themes specific to the Black experience. These include adding more sessions at the front end to better establish rapport, asking directly about race-related themes during the assessment process, and deliberately bringing to the forefront race-related experiences and discrimination during treatment when indicated. Guidelines for assessment and the development of appropriate exposures are provided. Case examples are presented demonstrating adaptation of PE for a survivor of race-related trauma and for a woman who developed internalized racism following a sexual assault. Both individuals experienced improvement in their posttrauma reactions using culturally-informed adaptations to PE.
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spelling pubmed-42192462014-11-06 Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans Williams, Monnica T. Malcoun, Emily Sawyer, Broderick A. Davis, Darlene M. Bahojb Nouri, Leyla Bruce, Simone Leavell Behav Sci (Basel) Article Posttraumatic stress disorder (PTSD) is a highly disabling disorder, afflicting African Americans at disproportionately higher rates than the general population. When receiving treatment, African Americans may feel differently towards a European American clinician due to cultural mistrust. Furthermore, racism and discrimination experienced before or during the traumatic event may compound posttrauma reactions, impacting the severity of symptoms. Failure to adapt treatment approaches to encompass cultural differences and racism-related traumas may decrease treatment success for African American clients. Cognitive behavioral treatment approaches are highly effective, and Prolonged Exposure (PE) in particular has the most empirical support for the treatment of PTSD. This article discusses culturally-informed adaptations of PE that incorporates race-related trauma themes specific to the Black experience. These include adding more sessions at the front end to better establish rapport, asking directly about race-related themes during the assessment process, and deliberately bringing to the forefront race-related experiences and discrimination during treatment when indicated. Guidelines for assessment and the development of appropriate exposures are provided. Case examples are presented demonstrating adaptation of PE for a survivor of race-related trauma and for a woman who developed internalized racism following a sexual assault. Both individuals experienced improvement in their posttrauma reactions using culturally-informed adaptations to PE. MDPI 2014-05-14 /pmc/articles/PMC4219246/ /pubmed/25379272 http://dx.doi.org/10.3390/bs4020102 Text en © 2014 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
spellingShingle Article
Williams, Monnica T.
Malcoun, Emily
Sawyer, Broderick A.
Davis, Darlene M.
Bahojb Nouri, Leyla
Bruce, Simone Leavell
Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans
title Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans
title_full Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans
title_fullStr Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans
title_full_unstemmed Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans
title_short Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans
title_sort cultural adaptations of prolonged exposure therapy for treatment and prevention of posttraumatic stress disorder in african americans
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219246/
https://www.ncbi.nlm.nih.gov/pubmed/25379272
http://dx.doi.org/10.3390/bs4020102
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