Table 4.
Treatment modifications of each patient
| No | Number of treatment sessions | Modification regarding treatment content (PRACTICE), material and setting |
|---|---|---|
| 1 | 12 sessions | A: terms for emotions were not known in mother tongue; practicing naming feelings, use of face feelings cards and skills box |
| T: creating a life-line before starting the trauma narrative | ||
| C: therapist was more directive in cognitive processing II | ||
| 2 | 12 sessions | P: psychoeducation about asylum procedure and asylum right in Germany |
| R: practicing several different relaxation techniques | ||
| A: using a feelings game; more time was spent describing and classifying feelings | ||
| 3 | 25 sessions | A: 6 sessions were spent naming and regulating feelings |
| T: 12 sessions were spent creating the trauma narrative | ||
| E: focus on enhancing a feeling of safety over 4 sessions (What makes me feel safe in Germany? How can I get a perspective in Germany?) | ||
| Less caregiver involvement (3 sessions). The patient was accompanied by a translator especially at the beginning of therapy and during trauma narrative. He only translated when necessary. | ||
| 4 | 12 sessions | -- |
| 5 | 25 sessions | P: psychoeducation about dissociation |
| R: practicing more relaxation techniques over 3 sessions; PMR was practiced in almost every session. | ||
| A: feelings were named in both languages; skills for emotion regulation; more time was spent describing and classifying feelings | ||
| T: trauma narrative was written in both languages, was created over 15 sessions; to prevent dissociation the patient walked around during the creation of the narrative | ||
| C: more time was spent on cognitive processing II | ||
| E: enhancing feeling of safety regarding Germany as a safe country | ||
| 6 | 28 sessions | A: 5 sessions were spent naming and regulating feelings |
| T: the trauma narrative has been audio-recorded without stopping to translate; it was translated in full afterwards; 16 sessions were spent on creating the trauma narrative. | ||
| E: focus on feeling of safety and looking back (4 sessions; e.g. feeling safe in Germany; how would life have been different if there had been peace in Afghanistan; how to deal with uncertainty about whether family is alive). | ||
| Less caregiver involvement (3 sessions). A translator attended therapy as a companion and the trauma narrative was shared with him. |
P psychoeducation, R relaxation, A affective modulation, C cognitive processing II, T trauma narrative, E enhancing future safety