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COGNITIVE RESTRUCTURING WITHIN RELIVING: A TREATMENT FOR PERITRAUMATIC EMOTIONAL “HOTSPOTS” IN POSTTRAUMATIC STRESS DISORDER

Published online by Cambridge University Press:  05 February 2002

Nick Grey ,
Kerry Young  and
Emily Holmes
Nick Grey
Affiliation:
Centre for Anxiety Disorders and Trauma, London, UK
Kerry Young
Affiliation:
Traumatic Stress Clinic, London, UK
Emily Holmes
Affiliation:
Traumatic Stress Clinic, London, UK University College, London, UK
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Abstract

This paper describes a distinct clinical approach to the treatment of Posttraumatic Stress Disorder (PTSD). It is theoretically guided by recent cognitive models of PTSD and explicitly combines cognitive therapy techniques within exposure/reliving procedures. A clinically pertinent distinction is made between the cognitions and emotions experienced at the time of the trauma and, subsequently, in flashback experiences, and secondary negative appraisals. The term peritraumatic emotional “hotspot” is used to describe moments of peak distress during trauma. It is argued that a focus on cognitively restructuring these peritraumatic emotional hotspots within reliving can significantly improve the effectiveness of the treatment of PTSD and help explain some treatment failures with traditional prolonged exposure. An approach to the identification and treatment of these hotspots is detailed for a range of cognitions and emotions not limited to fear.

Keywords

Posttraumatic stress disorderPTSDcognitive behaviour therapy“hotspots”
Type
Empirically Grounded Clinical Interventions Section
Information
Behavioural and Cognitive Psychotherapy , Volume 30 , Issue 1 , January 2002 , pp. 37 - 56
Copyright
© 2002 British Association for Behavioural and Cognitive Psychotherapies

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