Impact of compassion-focused psychodynamic trauma therapy on the resilience of trauma therapists Claudia L. Orellana-Rios, Stefan Schmidt and Luise Reddemann, Clinic for Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Germany Clinic for Palliative Medicine, Medical Center, University of Freiburg, Germany 14.07.2018
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Impact of compassion-focused psychodynamic
trauma therapy on the resilience of trauma
therapists
Claudia L. Orellana-Rios, Stefan Schmidt and Luise Reddemann,
Clinic for Psychosomatic Medicine and Psychotherapy, Medical Center, University of
Freiburg, Germany
Clinic for Palliative Medicine, Medical Center, University of Freiburg, Germany
14.07.2018
Background
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• Trauma therapists,specially of complex traumatized patients, are exposed to high emotional stress (Reddemann, 2001)
• Secondary traumatization
→ traumatization without sensory perception
→ cummulative empathizing
Online survey (n =1124):
30% of the surveyed
German trauma therapists
reported moderate to severe PTSD symptoms (Daniels, 2006)
Effects of the PITT Method on psychotherapists -
Anecdotical reports
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„PITT brings relieve to the patient but reduces
also the therapist burden“
Effects of the PITT Method on psychotherapists
Well-being – Anecdotical reports
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Focus on compassion, ressources and self-healing rather
than neutrality and confrontation
Feels coherent for the therapists
Is emotionally less exhausting
Focus on therapistʼs self-compassion and self-soothing skills:
Allows connectedness with the patients suffering from a
common-humanity perspective →Prerequisite for building
a compassionate working alliance
Fosters therapist confidence in the patients capability for
developing self-soothing skills and self-compassion
Self-care, mindfulness and compassion practices
Boosts therapist ressources
Builds an inner counterweight during confrontation
Interaction
aspect
Individual
aspect
The PITT curriculum for
psychotherapists
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3 modules (3 days each) over the period of a year
• Self-Experience → 50% of the training
First module
- Diagnostic aspects
- Transferance and countertransferance
- Stabilization though PITT (strenghtening of
ego functions)
Technique examples:
- Mindful description of daily joy
moments/ Mindful body perception
- Ressource Suitcase/ Joy biography
- Finding Horror counterimages
- Compassion practices
Second Module
- Ego state work with wounded inner states
- Ego-state work with perpetrator introjects
- Dealing with dissociative behavior
Technique examples:
- Inner safe space/ Inner helpers
- Inner stage concept
- - Integration of perpetrator introjects
through reconciliation
Third module
- Trauma confrontation with the observer
technique
Technique examples
- Distancing techniques: the TV-
Screen Exercise
- Affect-regulation techniques
- Observer technique
Aim
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To explore the effect of a PITT Training on
the psychological distress and the
resilience skills of trauma therapists
Study Design
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Single arm interventional-study with 3 measurement times: Prä, Post and
Follow-Up
At training After training 6-months
start completion after training (t1) (t2) (t3)
Training day 1 1 year later 1,5 years later
Cohorts from 5 cities across Germany:
Heidelberg (2x), Münster, München, Berlin
and Bernried
6 training cohorts
96 therapists
recruited,
60 completed 2
measurement
times
48 completed all 3
Completion rate =
46%
Methods
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Quantitative Measurements (online survey)
- Questionnaires and visual analogue scales
- Maslach Burnout Inventory for the social services (MBI)