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

Background: 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. Methods: 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. Results: 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. Conclusion: 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

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

Background: 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 directlyMethods: 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.Findings: 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.Conclusions: Trauma/grief focused group play therapy may be effective in reducing post traumatic symptoms of natural disasters in preschool aged children

Behavioral group therapy effect on Bam earthquake related PTSD symptoms in children: A randomized clinical trial

Background: In children and adolescents physical and psychological integrity threatening occur after disasters, whereby post traumatic stress disorder (PTSD) may be the first reaction. Psychological debriefing is a way for prevention and reducing PTSD symptoms. Many studies have shown the efficacy of behavioral therapy in treatment of post-traumatic stress disorder. Few evidence is available for using these techniques in combination for prevention and treatment of PTSD symptoms. This study compared the efficacy of psychological debriefing and cognitive behavioral group therapy combination on Bam earthquake related PTSD symptoms in children with a control group. Methods: In a control trial, we evaluated the efficacy of one session psychological debriefing and three sessions of group behavioral therapy in Bam earthquake adolescent survivors with PTSD symptoms and compared it with a control group. The mean age of participants was 9.07 (SD=1.7) years and no one had sever PTSD or other psychiatric disorder that needed pharmacological interventions. Before and after interventions we evaluated PTSD symptoms by use of K-SADS questionnaire and compared them with the control group. Results: The study included 100 persons, of whom 20 persons were excluded during intervention because of migration. The mean values of total PTSD symptoms and the symptoms of re-experience and avoidance were reduced after interventions. This reduction was statistically significant only for symptoms of re-experience. In control group the mean values of PTSD symptoms increased during study which was statistically significant. The two groups showed statistically significant differences of symptom reduction in total PTSD symptoms, re-experience and avoidance. No difference was detected for hyper arousal. Conclusion: Psychological debriefing and group behavioral therapy may have preventive effect on PTSD symptoms and may reduce symptoms of re-experience