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Resource activation for treating post-traumatic stress disorder, co-morbid symptoms and impaired functioning: a randomized controlled trial in Cambodia

Published online by Cambridge University Press:  02 November 2016

C. Steinert ,
P. J. Bumke ,
R. L. Hollekamp ,
A. Larisch ,
F. Leichsenring ,
H. Mattheß ,
S. Sek ,
U. Sodemann ,
M. Stingl  and
T. Ret
...Show all authors
C. Steinert*
Affiliation:
University of Giessen, Clinic for Psychosomatic Medicine and Psychotherapy, Ludwigstrasse 76, Giessen, Germany
P. J. Bumke
Affiliation:
Trauma Aid Germany, Schillerstrasse 6, Berlin, Germany
R. L. Hollekamp
Affiliation:
University of Giessen, Clinic for Psychosomatic Medicine and Psychotherapy, Ludwigstrasse 76, Giessen, Germany
A. Larisch
Affiliation:
University of Giessen, Clinic for Psychosomatic Medicine and Psychotherapy, Friedrichstrasse 33, Giessen, Germany
F. Leichsenring
Affiliation:
University of Giessen, Clinic for Psychosomatic Medicine and Psychotherapy, Ludwigstrasse 76, Giessen, Germany
H. Mattheß
Affiliation:
Psychotraumatology Institute Europe, Großenbaumer Allee 35a, Duisburg, Germany
S. Sek
Affiliation:
Department of Psychology, The Royal University of Phnom Penh, Russian Federation Boulevard, Toul Kork, Phnom Penh, Cambodia
U. Sodemann
Affiliation:
Trauma Aid Germany, In den Floragärten 41, Berlin, Germany
M. Stingl
Affiliation:
University of Giessen, Clinic for Psychosomatic Medicine and Psychotherapy, Ludwigstrasse 76, Giessen, Germany
T. Ret
Affiliation:
Department of Psychology, The Royal University of Phnom Penh, Russian Federation Boulevard, Toul Kork, Phnom Penh, Cambodia
H. Vojtová
Affiliation:
Slovak Institute for Psychotraumatology and EMDR, Legionarska 29, Trencin, Slovakia Charles University, Center for Neuropsychiatric Research of Traumatic Stress, Prague, Ke Karlovu 11, Prague, Czech Republic
W. Wöller
Affiliation:
Rhein-Klinik, Hospital for Psychsomatic Medicine and Psychotherapy, Luisenstrasse 3, Bad Honnef, Germany
J. Kruse
Affiliation:
University of Giessen, Clinic for Psychosomatic Medicine and Psychotherapy, Friedrichstrasse 33, Giessen, Germany University of Marburg, Clinic for Psychosomatic Medicine and Psychotherapy, Baldingerstrasse, Marburg, Germany
*
*Address for correspondence: C. Steinert, Ph.D., University of Giessen, Clinic for Psychosomatic Medicine and Psychotherapy, Ludwigstrasse 76, 35392 Giessen, Germany. (Email: [email protected])
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Abstract

Background

Mental health morbidity in post-conflict settings is high. Nevertheless, randomized controlled trials of psychotherapy on site are rare. Our aim was to integrate rigorous research procedures into a humanitarian programme and test the efficacy of resource activation (ROTATE) in treating post-traumatic stress disorder (PTSD), co-morbid symptoms and impaired functioning in Cambodia.

Method

A total of 86 out-patients with PTSD were randomly assigned to five sessions of ROTATE (n = 53) or a 5-week waiting-list control (WLC) condition (n = 33). Treatment was provided by six Cambodian psychologists who had received extensive training in ROTATE. Masked assessments were made before and after therapy.

Results

PTSD remission rates according to the DSM-IV algorithm of the Harvard Trauma Questionnaire were 95.9% in ROTATE and 24.1% in the WLC condition. Thus, patients receiving ROTATE had a significantly higher likelihood of PTSD remission (odds ratio 0.012, 95% confidence interval 0.002–0.071, p < 0.00001). Additionally, levels of anxiety, depression and impaired functioning were significantly reduced compared with the WLC condition (p < 0.00001, between-group effect sizes d = 2.41, 2.26 and 2.54, respectively). No harms were reported.

Conclusions

ROTATE was efficacious in treating Cambodian patients with high symptom levels of PTSD, emotional distress and impaired functioning. ROTATE is a brief, culturally adaptable intervention focusing on stabilization and strengthening resources rather than trauma confrontation. It can be taught to local professionals and paraprofessionals and enhance access to mental health care for patients in need.

Keywords

Cambodiapost-traumatic stress disorderpsychotherapyrandomized controlled trialsresource activation
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 3 , February 2017 , pp. 553 - 564
Copyright
Copyright © Cambridge University Press 2016 

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