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[0] Prolonged exposure (either in vivo exposure or trauma reliving in therapy) [2] A target image related to the trauma is used as a starting point, with a non−directive approach to what follows. Patient is encouraged to “let whatever happens happen.” Discussions with the therapist are intermittent. [3] The traumatic events are discussed, but the specific approach of prolonged exposure is not included. (In practice psychodynamic psychotherapy and cognitive behavioral therapy are often combined.) [4] Non−directive approach to the way trauma comes up and is processed, with encouragement to stay present rather than distracting from difficult memories and emotions. Discussions with the therapists are intermittent. (Note that a contract is made before the session that if the trauma does not come up spontaneously the therapist will bring it up, but thus far trauma has always come up spontaneously; in effect, prolonged exposure happens spontaneously. [1] 
For in vivo exposure, develop a hierarchy list of situations, and assign specific homework involving exposure to these situations. For imaginal exposure, ask the patient to describe the trauma in detail in the present tense. This is done repeatedly over a number of visits.
18 | June | 2007 | cannablog
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