Hintergrund: Das Störungsbild der komplexen Posttraumatischen Belastungsstörung (PTBS) tritt häufig nach wiederholten Gewalterfahrungen in der Kindheit und Jugend auf und zeichnet sich neben den Kernsymptomen der PTBS durch Störungen der Emotionsregulation, instabile Beziehungen sowie hohe Komorbiditäten aus. Viele Behandler haben Bedenken, bei dieser Patientengruppe expositionsbasierte Methoden anzuwenden. Die Cognitive Prozessing Therapy (CPT; [Resick et al., 2007]) stellt in ihrer rein kognitiven Variante (CPT-C) eine wirksame alternative Methode dar, die ohne formale Expositionselemente auskommt. Neben der Vorstellung dieser Behandlung wird ein Überblick über Evaluationsstudien gegeben sowie die Anwendung anhand eines Fallbeispiels beschrieben. Fallbericht: Die Patientin kam nach sexueller Gewalt im Kindesalter in die Behandlung. Neben einer PTBS wurde eine emotional instabile Persönlichkeitsstörung (Borderline-Typus) diagnostiziert. Die durchgeführten CPT-C-Interventionen, der Therapieverlauf sowie das Behandlungsergebnis werden beschrieben und Besonderheiten bei der Behandlung der komplexen PTBS aufgezeigt. Schlussfolgerungen: Die kognitive Variante der CPT, die CPT-C, ermöglicht es, auf eine formale Exposition zu verzichten, und zeigt dennoch eine genauso gute Wirksamkeit wie expositionsbasierte Methoden. Sie sollte deshalb in der Versorgung traumatisierter Patientinnen und Patienten und besonders auch zur Behandlung der komplexen PTBS eine größere Beachtung und Verbreitung finden.

Keywords:
Posttraumatische Belastungsstörung, Trauma, Emotionale Instabilität, Kognitive Therapie, Cognitive Processing Therapie
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2016
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