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Exposure therapy also helps patients with childhood trauma process the past

Childhood trauma can have a lifelong effect. Many therapists do not dare to confront these vulnerable patients with their past because they are concerned that the patients will be unable to cope. Research has now shown that exposure therapy can be helpful for this group of people.

Sexual abuse by a teacher or systematic abuse by a parent: people who have experienced something similar as a child is at considerable risk of developing post-traumatic stress disorder (PTSD). They carry the experience with them like a millstone around their neck, and it is not uncommon for these patients to develop a range of problems from depression to addiction and personality disorders.

Exposure therapy

New research has shown that exposure therapy can be of great benefit to these vulnerable patients. With this treatment method you return – in mind and if possible in body – to the place(s) where the trauma occurred. By repeating and reliving these difficult moments time and again, the patient learns that nothing disastrous happens if the terrifying memories surface. This can take away the fear.

Danielle Oprel and Chris Hoeboer, psychologists at PsyQ (Parnassia Group), conducted the research together with colleagues from, among others, Leiden University and Radboud University. They published their findings in the European Journal of Psychotraumatology

Decreased symptoms in over 70% of patients

In the study 149 patients with childhood trauma were treated with three different forms of exposure therapy. Although each of these different therapies produced a somewhat different result, one thing was blindingly clear: the symptoms reduced considerably in over 70% of the patients. The self-reports and clinical assessments showed that after the 16 sessions around half of the participants no longer had PTSD at all.

The results are striking because for a long time many therapists had thought that this vulnerable group would be unable to cope with exposure therapy. They were worried that the confrontation with the past would further destabilise the patient and possibly even increase the risk of suicide. The treatment was therefore mainly used on people who experienced trauma at a later age, such as war veterans.

Making it worse?

‘Our research shows that exposure therapy can actually make a difference to people with childhood trauma,’ says Martje Schoorl, professor by special appointment at the Clinical Psychology department and co-author of the study. ‘Many patients prove able to cope with reliving their trauma, as long as you provide good support. What is more: many patients already relive their traumas as it is, in their nightmares. You don’t need to worry about making it worse because it is bad already.’

Schoorl gives an example of the results of exposure therapy: ‘One patient had had traumatic experiences in a basement, which meant she wouldn’t even dare go into an underground space. After much practice she finally overcame her fear. That was amazing to see because it felt like a huge release for her. She now runs a webstore from her own basement.’

The research was funded with a grant from Innovatiefonds Zorgverzekeraars (an innovation fund provided by health insurers) and ZonMw. The ZonMw grant was within its Efficiency Studies programme. Here researchers investigate which treatment provides the best result for what price to ensure good, affordable health care.

Text: Merijn van Nuland

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