effect of supportive and cognitive- behavioral group therapy on bam earthquake survivors with post- traumatic stress disorder

Psychological debriefing is a way for prevention and reduction of post- traumatic stress disorder [PTSD] symptoms. Many studies have shown the efficacy of cognitive- behavioral therapy in treatment of post- traumatic stress disorder. Only some evidence is available about using these techniques in large scale disasters. This study was done to evaluate the efficacy of psychological debriefing and cognitive- behavioral group therapy combination on Bam earthquake related PTSD symptoms. In a before-after trial, we evaluated the effect of single session psychological debriefing and three sessions of group cognitive-behavioral therapy on PTSD symptoms of Bam earthquake survivors. Individuals with severe PTSD or other psychiatric disorders needing pharmacological interventions were excluded. Before, immediately and 3 months after interventions, we evaluated PTSD symptoms by clinically- administered PTSD scale for DSM-IV and analyzed them. 95 persons were included in the study; 11 and 25 people were excluded during the first month of interventions and the 3 month follow- up period, respectively, because of migration. The frequency of PTSD symptoms and the frequency, intensity and severity of avoidance symptoms reduced during 3 month period of study which was statistically significant [p<0.05]. No effect was obsereved regarding the frequency, intensity and severity of hyper- arousal, re-experience and the intensity and severity of total PTSD symptoms. Psychological debriefing and group cognitive- behavioral therapy may be effective on avoidance and the frequency of total PTSD symptoms

Trauma/Grief Group play therapy effect on Bam earthquake related emotional and behavioral symptoms in preschool children: a before after trial

Depressive, anxious, aggressive and regressive behaviors are the most common psychiatric symptoms following natural disasters in children. Art, play and behavioral techniques are used for reducing these traumatic symptoms. We studied the effect of 12 sessions of group play therapy in children 3 to 6 years old who had been exposed to the Bam earthquake directly. This study was carried out to evaluate the effect of 12 sessions of group play therapy with cognitive-behavioral approach for the preschool aged children who had been exposed to the Bam earthquake directly and had lost at least one of their first degree family members. Mental retarded children and those with psychiatric or severe medical problems that needed medications were excluded. Before and after interventions we evaluated post traumatic, emotional and anxiety symptoms by using Yule's PTSD scale and behavioral symptoms by Rutter's questionnaire. Then we compared before and after interventions scores. At first 19 children were included in the study, 13 of them completed at least two thirds of the interventional sessions. We excluded six children who participated in fewer sessions. The mean scores of Yule's PTSD scale and Rutter's questionaire reduced during interventions which was statistically significant. Trauma/grief focused group play therapy may be effective in reducing post traumatic symptoms of natural disasters in preschool aged children

[Supportive and cognitive behavioral group interventions on Bam earthquake related PTSD symptoms in adolescents]

Psychological debriefing has been widely advocated for routine use following major traumatic events. Cognitive Behavioral Interventions, art supportive therapies, and sport and recreational support activities are other interventions for reducing posttraumatic stress disorder. We assessed the effects of theses methods individually and in combination on reduction posttraumatic stress disorder symptoms in adolescents who had experienced Bam earthquake. In a field trial, we evaluated the efficacy of psychological debriefing, group cognitive-behavioral therapy, art and sport supportive interventions in 200 adolescents with PTSD symptoms who survived of Bam earthquake and compare it with a control group. Patients were randomly assigned to one of intervention programs including: group cognitive-behavioral therapy; group CBT plus art and sport interventions; art and sport interventions without group CBT; and control group. Thirty one individuals were excluded because of migration. A statistically significant reduction in overall PTSD symptoms as well as in avoidance symptoms was observed after group cognitive-behavioral therapy. There was no significant difference in reduction of overall PTSD and avoidance symptoms between the other groups. Psychological interventions in form of group cognitive behavioral therapy can reduce the symptoms of PTSD symptoms but we couldn't find the art and sport supportive therapy alone or in combination with group CBT to be useful in this regard

[ effect of psychosocial supportive interventions on PTSD symptoms after Bam earthquake]

Many studies have shown the efficacy of cognitive' behavioral therapy and psychological debriefing in treatment of post traumatic stress disorder [PTSD] and a few evidences are available for using these techniques in large scale disasters. This study aimed to asses the effect of some psychological interventions in reducing PTSD symptoms after Bam earthquake in different age groups. In a before-after quasi experimental clinical trial, we compared the efficacy of one session of psychological debriefing and three sessions of group cognitive-behavioral therapy in bam earthquake PTSD symptoms in different age groups. We evaluated PTSD symptoms before and immediately and three months after interventions by CASP scaling system and analyzed data. one hundred and thirty persons entered in the study and 51 persons excluded during interventions because of migration. Interventions were showed to be effective only in short term period. The means of PTSD symptoms frequency and severity of avoidance symptoms were reduced during three months period of study which were statistically significant P<0.05. Interventions showed no efficacy for recall symptoms in long term and hyper arousal symptoms in short term and long term periods. There was no statistically significant difference among age groups. Psychosocial supportive interventions may be effective on some of the PTSD symptoms but there is no difference in different age groups