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Cognitive trauma therapy for formerly battered women* with PTSD: Conceptual bases and treatment outlines*,

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This article describes the conceptual bases and treatment outlines of Cognitive Trauma Therapy for Formerly Battered Women with PTSD (CTT-BW), a psychoeducational, multicomponent, cognitive-behavioral intervention aimed at alleviating posttraumatic stress disorder (PTSD), depression, guilt, shame, and negative self-esteem in formerly battered women. CTT-BW is derived from psychological learning principles, and emphasizes the role of irrational beliefs and evaluative language in posttraumatic stress. Assessment and assessment instrumentation used in CTT-BW are described. The main treatment components in CTT-BW include (1) exploration of partner abuse history and exposure to other trauma; (2) psychoeducation on PTSD; (3) negotiation of imaginal and in vivo exposure homework; (4) psychoeducation on maladaptive self-talk; (5) stress management and relaxation training; (6) cognitive therapy for trauma-related guilt (Kubany & Manke, 1995); (7) psychoeducation on assertiveness and responses to verbal aggression; (8) managing unwanted contacts with former partners; (9) learning to identify potential perpetrators and avoid revictimization; and (10) psychoeducation on positive coping strategies that focus on self-advocacy and self-empowerment (e.g., placing oneself first, decision-making that promotes self interest). Homework includes listening to audiotapes of the sessions, in-vivo and imaginal exposure to abuse-related reminders, playing a relaxation tape, and self-monitoring of negative self-talk. Initial evidence for the efficacy of CTT-BW is discussed, as are issues that need to be addressed before CTT-BW can be reliably implemented and evaluated by other clinicians.

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    *

    This material is the result of work supported in part by resources and the use of facilities at the Department of Veterans Affairs, Honolulu, Hawaii.

    *

    We use the term “formerly battered women” to refer to women who are no longer in abusive relationships, who have no intention of reconciling, and who are considered relatively safe. The intervention described in this article was not designed for women who are still in abusive relationships or are considering reconciliation.

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