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TF-CBT and EMDR for young people with trauma and first episode psychosis (using a phasic treatment approach): two early intervention service case studies

Published online by Cambridge University Press:  26 October 2018

Joanna Ward-Brown ,
David Keane ,
Gita Bhutani ,
Debbie Malkin ,
Bill Sellwood  and
Filippo Varese
Joanna Ward-Brown
Affiliation:
Greater Manchester Mental Health NHS Foundation Trust
David Keane*
Affiliation:
Lancashire Traumatic Stress Service, Lancashire Care NHS Foundation Trust
Gita Bhutani
Affiliation:
Lancashire Traumatic Stress Service, Lancashire Care NHS Foundation Trust
Debbie Malkin
Affiliation:
Lancashire Traumatic Stress Service, Lancashire Care NHS Foundation Trust
Bill Sellwood
Affiliation:
Lancaster University
Filippo Varese
Affiliation:
University of Manchester
*
Author for correspondence: David Keane, Senior Cognitive Therapist and EMDR Consultant, Lancashire Traumatic Stress Service, 18 Euxton Lane, Chorley (email: David.Keane@lancashirecare.nhs.uk).
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Abstract

The relationship between trauma and psychosis is well established with a large amount of overlap between the ICD/DSM (International Classification of Diseases/Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria for post-traumatic stress disorder (PTSD) and psychosis and/or schizophrenia. In spite of co-morbidity and evidence of the links and underlying mechanisms, trauma is rarely a focus of intervention in psychosis. Psychosis has often been on the list of exclusion criteria for PTSD research studies. There is a lack of literature on the impact of trauma work with people experiencing psychosis. The National Institute for Health and Care Excellence (NICE) (2014) suggests that Early Intervention in Psychosis (EIP) service users should be assessed for PTSD, and PTSD guidelines (NICE, 2005) followed for those who show signs of post-traumatic stress. There is a need to evaluate the effectiveness of therapeutic approaches for people with PTSD and co-morbid psychosis. These case studies aim to provide initial evidence of how two EIP clients experienced and responded to NICE-recommended psychological therapy for trauma. This study aims to test the feasibility of trauma work delivered via a phasic approach in a novel population. Two EIP clients received psychological therapy [including trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR)] for identified traumatic experiences. Assessment outcome measures were utilized to establish the effectiveness of the interventions. Both clients reported significant improvements following therapy, including reduced trauma-related distress, reduced distress from symptoms of psychosis and improved quality of life. Clients with co-morbid PTSD and symptoms of psychosis are likely to benefit from recommended psychological treatments for PTSD. Further research is required to address generalizability to a larger population.

Keywords

traumaPTSDpsychosisEMDRTF-CBTearly intervention
Type
Practice Article
Information
the Cognitive Behaviour Therapist , Volume 11 , 2018 , e17
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

Further reading

de Bont, M, van den Berg, DP, van der Vleugel, BM (2013a). Multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and comorbid post-traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis (T-TIP). Trials 14, 151. https://doi.org/10.1186/1745-6215-14-151Google Scholar
de Bont, PA, van Minnen, A, de Jongh, A (2013b). Treating PTSD in patients with psychosis: a within group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols. Behaviour Therapy 44, 717–730.Google Scholar
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, van Os, J, Bentall, R (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671. doi: 10.1093/schbul/sbs0505Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
Baird, K, Kracen, AC (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Counselling Psychology Quarterly 19, 181–188.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1993). Manual for the Beck Anxiety Inventory. San Antonio, TX: The Psychological Corporation.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1996). Manual for the Beck Depression Inventory (2nd edn), San Antonio, TX: The Psychological Corporation.Google Scholar
Becker, CB, Zayfert, C, Anderson, E (2004). A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD. Behaviour Research and Therapy 42, 277–292.Google Scholar
Bentall, RP, Wickham, S, Shevlin, M, Varese, F (2012). Do specific early-life adversities lead to specific symptoms of psychosis? Schizophrenia Bulletin 38, 734–740.Google Scholar
Bernstein, EM, Putnam, FW (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease 174, 727–735.Google Scholar
Blake, DD, Weathers, FW, Nagy, LM, Kaloupek, DG, Gusman, FD, Charney, DS, Keane, TM (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress 8, 75–90.Google Scholar
Carlson, EB, Putnam, FW (1993). An update on the Dissociative Experiences Scale. Dissociation 1, 1.Google Scholar
Cloitre, M, Courtois, CA, Charuvastra, A, Carapezza, R, Stolbach, BC, Green, BL (2011). Treatment of complex PTSD: results of the ISTSS Expert Clinician Survey on best practice. Journal of Traumatic Stress 24, 615–627.Google Scholar
Creamer, M, Bell, R, Faillan, S (2003). Psychometric properties of the Impact of Event Scale – Revised. Behavioural Research and Therapy 4, 1489–1496.Google Scholar
de Bont, M, van den Berg, DP, van der Vleugel, BM (2013a). Multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and comorbid post-traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis (T-TIP). Trials 14, 151. https://doi.org/10.1186/1745-6215-14-151Google Scholar
de Bont, PA, van Minnen, A, de Jongh, A (2013b). Treating PTSD in patients with psychosis: a within-group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols. Behaviour Therapy 44, 717–730.Google Scholar
Drake, R, Haddock, G, Tarrier, N, Bentall, R, Lewis, S (2007). The Psychotic symptom rating scales (PSYRATS): their usefulness and properties in first episode psychosis. Schizophrenia Research 89, 119–122.Google Scholar
Ehlers, A, Clark, DM (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319–345.Google Scholar
Foa, EB, Hembree, EA, Rothbaum, BO (2007). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences. Therapist Guide. Oxford, UK: Oxford University Press.Google Scholar
Foa, EB, Tolin, DF (2000). Comparison of the PTSD Symptom Scale-Interview Version and the Clinician-Administered PTSD scale. Journal of Traumatic Stress 13, 181–191.Google Scholar
Frueh, BC, Grubaugh, AL, Cusack, KJ, Kimble, MO, Elhai, JD, Knapp, RG (2009). Exposure-based cognitive-behavioral treatment of PTSD in adults with schizophrenia or schizoaffective disorder: a pilot study. Journal of Anxiety Disorders 23, 665–675.Google Scholar
Greenwood, KE, Sweeney, A, Williams, S, Garety, P, Kuipers, E, Scott, J, Peters, E (2010). Choice of outcome in CBT for psychosis (CHOICE): the development of a new service-user led outcome measure of CBT for psychosis. Schizophrenia Bulletin 36, 126–135.Google Scholar
Horowitz, M, Wilner, N, Alvarez, W (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine 41, 209–218.Google Scholar
Hovens, JE, Van Der Ploeg, HM, Klaarenbeek, MTA, Bramsen, I, Schreuder, JN, Rivero, VV (1994). The assessment of posttraumatic stress dsorder with the Clinician Administered PTSD Scale: Dutch results. Journal of Clinical Psychology 50, 325–340.Google Scholar
Howgego, IM, Owen, C, Meldrum, L, Yellowlees, P, Dark, F, Parslow, R (2005). Post-traumatic stress disorder: an exploratory study examining rates of trauma and PTSD and its effects on client outcomes in community mental health. BMC Psychiatry 5, 21.Google Scholar
Johnson, LD, Duncan, BL, Miller, SD, Spark, JA, Claud, DA, Reynolds, LR, Brown, J (2003). The Session Rating Scale: preliminary psychometric properties of a ‘working’ alliance measure. Journal of Brief Therapy 3.Google Scholar
Krakow, B, Zadra, A (2010). Imagery rehearsal therapy: principles and practice. Elsevier Sleep Medicine Clinics 5, 289–298.Google Scholar
Lowe, C, Murray, C (2014). Adult service-users’ experiences of trauma-focused cognitive behavioural therapy. Journal of Contemporary Psychotherapy 44. doi: 10.1007/s10879-014-9272-1Google Scholar
Meyer, JM, Farrell, NR, Kemp, JJ, Blakey, SM, Deacon, BJ (2014). Why do clinicians exclude anxious clients from exposure therapy? Behaviour Research and Therapy 54, 49–53.Google Scholar
Morrison, AP, Frame, L, Larkin, W (2003). Relationships between trauma and psychosis: a review and integration. British Journal of Clinical Psychology 42, 331–353.Google Scholar
Mueser, KT, Rosenberg, SD, Fox, L, Salyers, MP, Ford, JD, Carty, P (2001). Psychometric evaluation of trauma and posttraumatic stress disorder assessments in persons with severe mental illness. Psychological Assessment 13, 110–117.Google Scholar
National Institute for Health and Care Excellence (NICE) (2005). Post-traumatic stress disorder: management. Clinical guideline [CG26].Google Scholar
National Institute for Health and Care Excellence (NICE) (2014). Psychosis and schizophrenia in adults: prevention and management. Clinical guideline [CG178].Google Scholar
NHS England, the National Collaborating Centre for Mental Health and the National Institute for Health and Care Excellence (2016). Implementing the Early Intervention in Psychosis Access and Waiting Time Standard: Guidance. NHS England Publications Gateway reference 04294.Google Scholar
Nugter, MA, Engelsbel, F, Bähler, M, Keet, R, van Veldhuizen, R (2015). Outcomes of Flexible Assertive Community Treatment (FACT) implementation: a prospective real life study. Community Mental Health Journal 52, 898–907.Google Scholar
Phillips, KFV, Power, MJ (2007). A new self-report measure of emotion regulation in adolescents: the Regulation of Emotions Questionnaire. Clinical Psychology and Psychotherapy 14, 145–156.Google Scholar
Power, MJ (2006). The structure of emotion: an empirical comparison of six models. Cognition and Emotion 20, 694–713.Google Scholar
Power, M, Fyvie, C (2013). The role of emotions in PTSD: two preliminary studies. Behavioural and Cognitive Psychotherapy 41, 162–172.Google Scholar
Raskind, MA, Peterson, K, Williams, T, Hoff, DJ, Hart, K, Holmes, H, Homas, D, Hill, J, Daniels, C, Calohan, J, Millard, SP, Rohde, K, O'Connell, J, Pritzl, D, Feiszli, K, Petrie, EC, Gross, C, Mayer, CL, Freed, MC, Engel, C, Peskind, ER (2013). A trial of prazosin for combat trauma PTSD with nightmares in active-duty soldiers returned from Iraq and Afghanistan. American Journal of Psychiatry 170, 1003–1010.Google Scholar
Read, J, Perry, BD, Moskowitz, A, Connolly, A (2001). The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry 64, 319–345.Google Scholar
Shapiro, F (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd edn). New York: Guilford Press.Google Scholar
Sitko, K, Bentall, RP, Shevlin, M, O'Sullivan, N, Sellwood, W (2014). Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey. Psychiatry Research 217, 202–209.Google Scholar
Spinazzola, J, Ford, JD, Zucker, M, van der Kolk, BA, Silva, S, Smith, SF, Blaustein, M (2005). Survey evaluates complex trauma exposure, outcome, and intervention among children and adolescents. Psychiatric Annals 35, 433–439.Google Scholar
Thomas, N, Hayward, M, Peters, E, van der Gaag, M, Bentall, RP, Jenner, J, Strauss, C, Sommer, IE, Johns, LC, Varese, F, Garcia-Montes, JM, Waters, F, Dodgson, G, McCarthy-Jones, S (2014). Psychological therapies for auditory hallucinations (voices): current status and key directions for future research. Schizophrenia Bulletin 40, S202–212. doi:10.1093/schbul/sbu037Google Scholar
van den Berg, DP, van der Gaag, M (2012). Treating trauma in psychosis with EMDR: a pilot study. Journal of Behavioural Therapy and Experimental Psychiatry 43, 664–671.Google Scholar
van den Berg, DPG, van der Vleugel, BM, Staring, ABP, De Bont, PAJ, de Jongh, A (2013). EMDR in psychosis: guidelines for conceptualization and treatment. Journal of EMDR Practice and Research 7, 208–224. https://doi.org/10.1891/1933-3196.7.4.208Google Scholar
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, van Os, J, Bentall, R (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671. doi: 10.1093/schbul/sbs0505Google Scholar
Watts, BV, Schnurr, PP, Mayo, L, Young-Xu, Y, Weeks, WB, Friedman, MJ (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry 74, e541–550. doi: 10.4088/JCP.12r08225Google Scholar
Weiss, DS, Marmar, CR (1997). The Impact of Event Scale-Revised, in Wilson, JP and Keane, TM (eds), Assessing Psychological Trauma and PTSD: A Practitioner's Handbook, pp. 399–411. New York: Guilford Press.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
Baird, K, Kracen, AC (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Counselling Psychology Quarterly 19, 181–188.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1993). Manual for the Beck Anxiety Inventory. San Antonio, TX: The Psychological Corporation.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1996). Manual for the Beck Depression Inventory (2nd edn), San Antonio, TX: The Psychological Corporation.Google Scholar
Becker, CB, Zayfert, C, Anderson, E (2004). A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD. Behaviour Research and Therapy 42, 277–292.Google Scholar
Bentall, RP, Wickham, S, Shevlin, M, Varese, F (2012). Do specific early-life adversities lead to specific symptoms of psychosis? Schizophrenia Bulletin 38, 734–740.Google Scholar
Bernstein, EM, Putnam, FW (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease 174, 727–735.Google Scholar
Blake, DD, Weathers, FW, Nagy, LM, Kaloupek, DG, Gusman, FD, Charney, DS, Keane, TM (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress 8, 75–90.Google Scholar
Carlson, EB, Putnam, FW (1993). An update on the Dissociative Experiences Scale. Dissociation 1, 1.Google Scholar
Cloitre, M, Courtois, CA, Charuvastra, A, Carapezza, R, Stolbach, BC, Green, BL (2011). Treatment of complex PTSD: results of the ISTSS Expert Clinician Survey on best practice. Journal of Traumatic Stress 24, 615–627.Google Scholar
Creamer, M, Bell, R, Faillan, S (2003). Psychometric properties of the Impact of Event Scale – Revised. Behavioural Research and Therapy 4, 1489–1496.Google Scholar
de Bont, M, van den Berg, DP, van der Vleugel, BM (2013a). Multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and comorbid post-traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis (T-TIP). Trials 14, 151. https://doi.org/10.1186/1745-6215-14-151Google Scholar
de Bont, PA, van Minnen, A, de Jongh, A (2013b). Treating PTSD in patients with psychosis: a within-group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols. Behaviour Therapy 44, 717–730.Google Scholar
Drake, R, Haddock, G, Tarrier, N, Bentall, R, Lewis, S (2007). The Psychotic symptom rating scales (PSYRATS): their usefulness and properties in first episode psychosis. Schizophrenia Research 89, 119–122.Google Scholar
Ehlers, A, Clark, DM (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319–345.Google Scholar
Foa, EB, Hembree, EA, Rothbaum, BO (2007). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences. Therapist Guide. Oxford, UK: Oxford University Press.Google Scholar
Foa, EB, Tolin, DF (2000). Comparison of the PTSD Symptom Scale-Interview Version and the Clinician-Administered PTSD scale. Journal of Traumatic Stress 13, 181–191.Google Scholar
Frueh, BC, Grubaugh, AL, Cusack, KJ, Kimble, MO, Elhai, JD, Knapp, RG (2009). Exposure-based cognitive-behavioral treatment of PTSD in adults with schizophrenia or schizoaffective disorder: a pilot study. Journal of Anxiety Disorders 23, 665–675.Google Scholar
Greenwood, KE, Sweeney, A, Williams, S, Garety, P, Kuipers, E, Scott, J, Peters, E (2010). Choice of outcome in CBT for psychosis (CHOICE): the development of a new service-user led outcome measure of CBT for psychosis. Schizophrenia Bulletin 36, 126–135.Google Scholar
Horowitz, M, Wilner, N, Alvarez, W (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine 41, 209–218.Google Scholar
Hovens, JE, Van Der Ploeg, HM, Klaarenbeek, MTA, Bramsen, I, Schreuder, JN, Rivero, VV (1994). The assessment of posttraumatic stress dsorder with the Clinician Administered PTSD Scale: Dutch results. Journal of Clinical Psychology 50, 325–340.Google Scholar
Howgego, IM, Owen, C, Meldrum, L, Yellowlees, P, Dark, F, Parslow, R (2005). Post-traumatic stress disorder: an exploratory study examining rates of trauma and PTSD and its effects on client outcomes in community mental health. BMC Psychiatry 5, 21.Google Scholar
Johnson, LD, Duncan, BL, Miller, SD, Spark, JA, Claud, DA, Reynolds, LR, Brown, J (2003). The Session Rating Scale: preliminary psychometric properties of a ‘working’ alliance measure. Journal of Brief Therapy 3.Google Scholar
Krakow, B, Zadra, A (2010). Imagery rehearsal therapy: principles and practice. Elsevier Sleep Medicine Clinics 5, 289–298.Google Scholar
Lowe, C, Murray, C (2014). Adult service-users’ experiences of trauma-focused cognitive behavioural therapy. Journal of Contemporary Psychotherapy 44. doi: 10.1007/s10879-014-9272-1Google Scholar
Meyer, JM, Farrell, NR, Kemp, JJ, Blakey, SM, Deacon, BJ (2014). Why do clinicians exclude anxious clients from exposure therapy? Behaviour Research and Therapy 54, 49–53.Google Scholar
Morrison, AP, Frame, L, Larkin, W (2003). Relationships between trauma and psychosis: a review and integration. British Journal of Clinical Psychology 42, 331–353.Google Scholar
Mueser, KT, Rosenberg, SD, Fox, L, Salyers, MP, Ford, JD, Carty, P (2001). Psychometric evaluation of trauma and posttraumatic stress disorder assessments in persons with severe mental illness. Psychological Assessment 13, 110–117.Google Scholar
National Institute for Health and Care Excellence (NICE) (2005). Post-traumatic stress disorder: management. Clinical guideline [CG26].Google Scholar
National Institute for Health and Care Excellence (NICE) (2014). Psychosis and schizophrenia in adults: prevention and management. Clinical guideline [CG178].Google Scholar
NHS England, the National Collaborating Centre for Mental Health and the National Institute for Health and Care Excellence (2016). Implementing the Early Intervention in Psychosis Access and Waiting Time Standard: Guidance. NHS England Publications Gateway reference 04294.Google Scholar
Nugter, MA, Engelsbel, F, Bähler, M, Keet, R, van Veldhuizen, R (2015). Outcomes of Flexible Assertive Community Treatment (FACT) implementation: a prospective real life study. Community Mental Health Journal 52, 898–907.Google Scholar
Phillips, KFV, Power, MJ (2007). A new self-report measure of emotion regulation in adolescents: the Regulation of Emotions Questionnaire. Clinical Psychology and Psychotherapy 14, 145–156.Google Scholar
Power, MJ (2006). The structure of emotion: an empirical comparison of six models. Cognition and Emotion 20, 694–713.Google Scholar
Power, M, Fyvie, C (2013). The role of emotions in PTSD: two preliminary studies. Behavioural and Cognitive Psychotherapy 41, 162–172.Google Scholar
Raskind, MA, Peterson, K, Williams, T, Hoff, DJ, Hart, K, Holmes, H, Homas, D, Hill, J, Daniels, C, Calohan, J, Millard, SP, Rohde, K, O'Connell, J, Pritzl, D, Feiszli, K, Petrie, EC, Gross, C, Mayer, CL, Freed, MC, Engel, C, Peskind, ER (2013). A trial of prazosin for combat trauma PTSD with nightmares in active-duty soldiers returned from Iraq and Afghanistan. American Journal of Psychiatry 170, 1003–1010.Google Scholar
Read, J, Perry, BD, Moskowitz, A, Connolly, A (2001). The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry 64, 319–345.Google Scholar
Shapiro, F (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd edn). New York: Guilford Press.Google Scholar
Sitko, K, Bentall, RP, Shevlin, M, O'Sullivan, N, Sellwood, W (2014). Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey. Psychiatry Research 217, 202–209.Google Scholar
Spinazzola, J, Ford, JD, Zucker, M, van der Kolk, BA, Silva, S, Smith, SF, Blaustein, M (2005). Survey evaluates complex trauma exposure, outcome, and intervention among children and adolescents. Psychiatric Annals 35, 433–439.Google Scholar
Thomas, N, Hayward, M, Peters, E, van der Gaag, M, Bentall, RP, Jenner, J, Strauss, C, Sommer, IE, Johns, LC, Varese, F, Garcia-Montes, JM, Waters, F, Dodgson, G, McCarthy-Jones, S (2014). Psychological therapies for auditory hallucinations (voices): current status and key directions for future research. Schizophrenia Bulletin 40, S202–212. doi:10.1093/schbul/sbu037Google Scholar
van den Berg, DP, van der Gaag, M (2012). Treating trauma in psychosis with EMDR: a pilot study. Journal of Behavioural Therapy and Experimental Psychiatry 43, 664–671.Google Scholar
van den Berg, DPG, van der Vleugel, BM, Staring, ABP, De Bont, PAJ, de Jongh, A (2013). EMDR in psychosis: guidelines for conceptualization and treatment. Journal of EMDR Practice and Research 7, 208–224. https://doi.org/10.1891/1933-3196.7.4.208Google Scholar
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, van Os, J, Bentall, R (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671. doi: 10.1093/schbul/sbs0505Google Scholar
Watts, BV, Schnurr, PP, Mayo, L, Young-Xu, Y, Weeks, WB, Friedman, MJ (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry 74, e541–550. doi: 10.4088/JCP.12r08225Google Scholar
Weiss, DS, Marmar, CR (1997). The Impact of Event Scale-Revised, in Wilson, JP and Keane, TM (eds), Assessing Psychological Trauma and PTSD: A Practitioner's Handbook, pp. 399–411. New York: Guilford Press.Google Scholar
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