Trauma focus group therapy for combat-related PTSD

Although individual therapy involving imaginal experiencing of the traumatic event has been found to be effective in treating PTSD, there is evidence that few trauma therapists actually use the technique. Moreover, symptom improvement has been found to favor intrusive symptoms, whereas avoidance and hyperarousal have been less affected. Additionally, there are several published reports documenting difficulties in implementing the treatment, ranging from client refusal, adverse reactions, and therapist inexperience. In this article we outline an alternative group form of exposure therapy, manualized trauma focus group therapy (TFGT), designed to overcome some of these implementation obstacles and to enhance the effects of imaginal exposure to include those chronic PTSD symptoms of avoidance and social isolation. We describe the cognitive behavioral and developmental models from which the approach was derived, present clinical guidelines and an illustrative session, discuss complications we have encountered in TFGT pilot studies, and offer suggestions for improving future implementation. © 1997 John Wiley & Sons, Inc.