Tratamiento Cognitivo-conductual de un Caso de Estrés Postraumático por Accidente Ferroviario. ¿Éxito Terapéutico o Evitación?

Abstract

This paper presents the case of a 53-year old woman with posttraumatic stress disorder (PTSD) after a train accident in Galicia (Spain) in July, 2013. The accident caused the patient several injuries and surgical interventions. The psychological impact is delayed and consists of PTSD symptoms, besides high anxiety, depression symptoms, and high anger. The treatment involved Prolonged Exposure into a broader cognitive-behavior therapy that included cognitive restructuring and training in emotional regulation to treat dysfunctional cognitive responses that promoted anger. The article describes the implementation of the treatment and the main difficulties encountered, namely, the avoidance of exposure to trauma memories and the premature end of the treatment at patient’s request. We present the results of the treatment, including 1, 3, 6, and 12 months follow-ups and discuss patient’s progression.