Treating PTSD in South African contexts : a theoretical framework and a model for developing evidence-based practice
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6231 , http://hdl.handle.net/10962/d1007781
- Description: Several psychological factors contribute to the development and maintenance of post-traumatic stress disorder (PTSD) because they interfere with the emotional processing of the traumatic event. These include problematic and painful emotions such as anxiety, shame, guilt and grief, distorted or dysfunctional cognitions, and cognitive, emotional, and behavioural avoidance mechanisms. Analysis of these maintaining factors provides the basis for current approaches to treatment which support traumatised individuals in facing emotional pain, working to resolve shame, grief and guilt, and expanding existing schemas to accommodate the traumatic event(s). Randomised controlled trials (RCTs) are reviewed in which the efficacy of some of these treatments have been evaluated. While many South African practitioners are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions, a great deal still needs to be done to build a sound research base for local practice in the treatment of PTSD and disseminating that research to practitioners in the field. It is recommended that a case-based evaluation strategy be used to complement the findings of international RCT studies in order to build a foundation of locally contextualised and applicable scientific knowledge.
- Full Text:
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6231 , http://hdl.handle.net/10962/d1007781
- Description: Several psychological factors contribute to the development and maintenance of post-traumatic stress disorder (PTSD) because they interfere with the emotional processing of the traumatic event. These include problematic and painful emotions such as anxiety, shame, guilt and grief, distorted or dysfunctional cognitions, and cognitive, emotional, and behavioural avoidance mechanisms. Analysis of these maintaining factors provides the basis for current approaches to treatment which support traumatised individuals in facing emotional pain, working to resolve shame, grief and guilt, and expanding existing schemas to accommodate the traumatic event(s). Randomised controlled trials (RCTs) are reviewed in which the efficacy of some of these treatments have been evaluated. While many South African practitioners are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions, a great deal still needs to be done to build a sound research base for local practice in the treatment of PTSD and disseminating that research to practitioners in the field. It is recommended that a case-based evaluation strategy be used to complement the findings of international RCT studies in order to build a foundation of locally contextualised and applicable scientific knowledge.
- Full Text:
Unconscious influences on discourses about consciousness : ideology, state-specific science and unformulated experience
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6226 , http://hdl.handle.net/10962/d1007776
- Description: Discussions about consciousness are complicated by the fact that participants do not share a common underlying “ordinary” consciousness. Everyday experience is founded on what Teasdale calls implicational cognition, much of which is not verbally formulated. An unacknowledged aspect of debate is individuals’ attempts to negotiate the expression of their unformulated experience. This is further complicated by the way in which a discourse, based on particular ontological assumptions, exercises an ideological control which limits what underlying aspects of experience can be formulated at all. Tart’s concept of state specific sciences provides a framework within which the role of unformulated experience can be acknowledged and taken into account. Unless this is done, debates will be vitiated by participants engaging in ideological struggles and talking at cross-purposes.
- Full Text:
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6226 , http://hdl.handle.net/10962/d1007776
- Description: Discussions about consciousness are complicated by the fact that participants do not share a common underlying “ordinary” consciousness. Everyday experience is founded on what Teasdale calls implicational cognition, much of which is not verbally formulated. An unacknowledged aspect of debate is individuals’ attempts to negotiate the expression of their unformulated experience. This is further complicated by the way in which a discourse, based on particular ontological assumptions, exercises an ideological control which limits what underlying aspects of experience can be formulated at all. Tart’s concept of state specific sciences provides a framework within which the role of unformulated experience can be acknowledged and taken into account. Unless this is done, debates will be vitiated by participants engaging in ideological struggles and talking at cross-purposes.
- Full Text: