Publications [#349123] of Kathleen J. Sikkema

Journal Articles

1. Sikkema, KJ; Coleman, JN (2019). Psychotherapy for PTSD and stress disorders. Global Mental Health and Psychotherapy: Adapting Psychotherapy for Low- and Middle-Income Countries, 193-222. [doi]
   (last updated on 2021/12/08)

   Abstract:
   © 2019 Elsevier Inc. All rights reserved. LMIC are affected by serious issues that contribute to the development of traumatic stress, such as war and conflict, internal displacement, poverty, food insecurity, and disease. Evidence-based psychological treatments for PTSD have been developed and tested in high-income countries, but less research has been conducted in LMIC to examine if similar treatments for PTSD are efficacious in various cultural contexts and within a range of delivery settings. In this chapter, we review psychological interventions for PTSD and stress disorders that have been evaluated in LMIC, provide an overview of their efficacy, synthesize the strengths and weaknesses of empirical work to date, and discuss future directions for research and treatment implementation. Resulting studies were organized by population stressor into the following sections: (American Psychiatric Association, 2013) conflict and violence, (Scott, Koenen, Aguilar-Gaxiola, et al., 2013) natural disasters, and (Turner & Lloyd, 1995) gender-based violence, including comorbid medical conditions. Existing interventions have several methodological strengths, such as numerous studies utilizing empirically supported approaches, group-based intervention structures, and delivery by nonspecialists in mental health (e.g., lay counselors or community health workers). The treatments evaluated are on a continuum of traditions from those in the CBT framework such as TF-CBT and NET to broader psychological treatments such as problem-solving, IPT, and BA. A limitation is that trials have largely compared treatments with a wait list control, no-treatment control, or treatment-as-usual condition. Therefore, for many PTSD trials, the extent of the effect attributable to treatment is not clear. Future directions should include testing mechanisms of change in treatment, developing brief and scalable interventions that have been culturally tailored, and using attention-matched control comparisons to elucidate effective treatment components.