Prolonged Exposure in the Treatment of PTSD Following an Apartment Fire

Abstract

Foa, Hembree, and Rothbaum’s Prolonged Exposure treatment manual has been found to be an effective treatment modality for posttraumatic stress disorder (PTSD) that is comparable with other evidence-based PTSD treatments. Although the manual details weekly 90-min sessions, this time frame is not always feasible for those clinicians who may be confined to a 50-min appointment. In addition, Foa et al.’s inclusion of audio and video for taped exposures is not always possible given some centers’ technological limitations and client finances. The current case summary details an adapted version of the manual that takes into account such limitations to treat a 26-year-old Jamaican-Canadian female who presented for treatment of PTSD following a fire destroying her home and possessions. Eighteen weekly 50- to 60-min sessions included components of psychoeducation, breathing retraining, in vivo exposures, imaginal exposures, and a trauma narrative (in replacement of audio/video exposures). From pre- to postassessment, significant gains were noted, including a reduction in intrusive thoughts and hyperarousal, and elimination of reexperiencing and sleep disturbances. At the conclusion of treatment, the client also demonstrated an ability to confront the trauma, memories, situations, activities, and places that she had avoided. Self-report measures further validated gains. Due to complicating factors, a follow-up evaluation was not able to be completed. Treatment complications, diversity factors, and implications for future work are discussed.