Лечение посттравматического стрессового расстройства у ветеранов боевых действий: руководство по использованию поведенческой терапии при тревоге и посттравматическом стрессовом расстройстве (BTAP)^*

Посттравматическое стрессовое расстройство (ПТСР) — это хроническое и дезадаптирующее состояние, связанное с психиатрическими и другими заболеваниями и снижением качества жизни. Ветераны боевых действий подвергаются повышенному риску развития ПТСР, и оно может хуже поддаваться лечению, чем у гражданского населения. Как пролонгированная экспозиция, так и терапия когнитивной обработки являются эмпирически подтвержденными методами лечения ПТСР у военнослужащих. Однако для их внедрения требуются значительные ресурсы, и поставщикам медицинских услуг, а также пациентам может быть трудно их освоить. Чтобы устранить эти ограничения, мы разработали поведенческую терапию тревоги и посттравматического стрессового расстройства (Behavioral Therapy for Anxiety and PTSD), которая представляет собой простую поведенческую терапию, основанную на теории обучения. Основываясь на эмпирически доказанных методах лечения, таких как пролонгированная экспозиция, поведенческая терапия тревоги и посттравматического стрессового расстройства, уделяется особое внимание выявлению, снижению и противодействию охранительному поведению, которое поддерживает ПТСР. Поскольку терапия фокусируется только на охранительном поведении, ее легко освоить и внедрить. Тренинги для терапевтов проводятся в течение одного дня, а последующие консультации проводятся по мере необходимости. В этой статье специального выпуска мы описываем протокол поведенческой терапии тревоги и ПТСР, а также приводим реальные примеры из практики, чтобы проиллюстрировать ключевые компоненты лечения. Мы также представляем данные пяти пациентов-ветеранов, демонстрирующие целесообразность, приемлемость и предварительные доказательства эффективности терапии. Пациенты сообщали о значительном снижении симптомов ПТСР и депрессии, а также навязчивых состояний и охранительного поведения. Эта работа предполагает, что поведенческая терапия тревоги и ПТСР требует дальнейшего изучения в качестве средства лечения ПТСР.

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