Person:

Herman, Judith

Background: This article provides a description of the rationale, design, and methods of a multisite clinical trial which evaluates the potential benefits of an evidence-based psychosocial treatment, STAIR Narrative Therapy, among women with posttraumatic stress disorder (PTSD) related to interpersonal violence who are seeking services in public sector community mental health clinics. This is the first large multisite trial of an evidence-based treatment for PTSD provided in the context of community settings that are dedicated to the treatment of poverty-level patient populations. Methods: The study is enrolling 352 participants in a minimum of 4 community clinics. Participants are randomized into either STAIR Narrative Therapy or Treatment As Usual (TAU). Primary outcomes are PTSD, emotion management and interpersonal problems. The study will allow a flexible application of the protocol determined by patient need and preferences. Secondary analyses will assess the relationship of outcomes to different patterns of treatment implementation for different levels of baseline symptom severity. Discussion The article discusses the rationale and study issues related to the use of a flexible delivery of a protocol treatment and of the selection of treatment as it is actually practiced in the community as the comparator. Trial registration Clinicaltrials.gov identifier: NCT01488539.

Fifty-three women outpatients participated in short-term therapy groups for incest survivors. This treatment modality proved to be a powerful stimulus for recovery of previously repressed traumatic memories. A relationship was observed between the age of onset, duration, and degree of violence of the abuse and the extent to which memory of the abuse had been repressed. Three out of four patients were able to validate their memories by obtaining corroborating evidence from other sources. The therapeutic function of recovering and validating traumatic memories is explored.

Subjects with borderline personality disorder (N = 21) or borderline traits (N = 11) and nonborderline subjects with closely related diagnoses (N = 23) were interviewed in depth regarding experiences of major childhood trauma. Significantly more borderline subjects (81%) gave histories of such trauma, including physical abuse (71%), sexual abuse (68%), and witnessing serious domestic violence (62%); abuse histories were less common in those with borderline traits and least common in the subjects with no borderline diagnosis. These results demonstrate a strong association between a diagnosis of borderline personality disorder and a history of abuse in childhood.

What are the meanings of justice, as seen from the perspective of victims of violent crime? Are victims’ visions of justice represented by the conventional legal system? Are they represented by restorative justice? The author engages these questions, drawing on in-depth interviews with 22 victims of violent crime. It is argued that survivors’ views of justice do not fit well into either retributive or restorative models. This has implications for current efforts to use restorative models in cases of violence against women.

Objective: There are no standard training programs for teaching psychotherapy supervisors effective, ethical, and legal aspects of supervision. This article describes an eight session training course containing essential information for supervisors.Methods: The literature on psychotherapy supervision was reviewed and an evening seminar series was offered to veteran supervisor The seminars were then translated into a course for faculty supervisors and trainees interested in becoming supervisors.Results: Participants completed a postcourse survey and ranked as high the quality and content of the course and course satisfaction on Likert scales. Participants felt well prepared and reported increased confidence in going forward in their supervisory roles.Conclusion: While current Residency Review Committee guidelines do not define standards for competency in psychotherapy supervision, the authors suggest that a course containing these principles of psychodynamic psychotherapy supervision be a prerequisite for those supervising residents. New and veteran supervisors reported learning essential aspects of supervision unknown before their course enrollment.

What are the meanings of justice, as seen from the perspective of victims of violent crime? Are victims' visions of justice represented by the conventional legal system? Are they represented by restorative justice? The author engages these questions, drawing on in-depth interviews with 22 victims of violent crime. It is argued that survivors' views of justice do not fit well into either retributive or restorative models. This has implications for current efforts to use restorative models in cases of violence against women.