Abstract

The aims of this study were to investigate the effects of cognitive-behavioral group therapy for posttraumatic stress disorder(PTSD) and explore the effectiveness and process variables of treatment. Clinician Administrated PTSD Scale was administered for diagnosis of 52 undergraduates victims who experienced the same bus accident. A total of 31 undergraduates victims who classified as full PTSD and subsyndromal PTSD participated in this study and cognitive-behavioral group therapy of ten weekly sessions were administered. The members of victims who completed the 3 months follow up assessment were 11 in treatment group and 12 in control group. The program was composed of teaching relaxation training, cognitive restructuring and stress inoculation training, treating image exposure and in vivo exposure, and dealing with anxiety, depression, active coping, life goals and existential problems. To examine the treatment effect, all victims completed the Clinician Administrated PTSD Scale, Impact of Event Scale, Beck Depression Inventory, State-Trait Anxiety Scale, State-Trait Anger Scale for pretest, middle test, post test and follow-up test. And paired t-test was used to analyze the outcome. The major results were as follows. First, in the prior phase, treatment group was significantly improved in depression, state anxiety and measures related PTSD(Impact of Event Scale, Clinician Administrated PTSD Scale, negligent guilt and derealization), but not significantly improved driving/riding behaviors as behavior measures. In the posterior phase, there were no significant differences all of measures related PTSD between treatment and control groups, but improved 'avoidance of certain roads', significantly only in 'avoid accident area', 'sensibility of speed' of driving/riding behaviors in treatment group and it could interpreted as the improvement of accident phobic symptom. In follow up assessment, there were no significant differences all of subjective and objective measures between the two groups. It was indicated that the effectiveness of cognitive-behavioral treatment could not exceeded spontaneous recovery of control group in follow up assessment. Second, therapeutic factors affecting the effectiveness of cognitive-behavioral group treatment were rated to be effective group cohesion, universality and catharsis. The most improved member and the least improved member were selected for case study to investigate process variables in cognitive-behavioral group treatment and their treatment process and change of PTSD symptom were prescribed by phenomenical form. These two members were differentiated in communication styles. The most improved member used more leading responses than the least improved member and the least improved member used assertion and insincerity responses than the most effective member in cognitive-behavioral group treatment. The suggestions and the limitations of this study, and the directions of future study were discussed.