Trauma-focused intervention after bone marrow transplantation: A case study

This paper describes the use of a Trauma-Focused Intervention (TFI) to reduce symptoms of posttraumatic stress disorder (PTSD) in a 40-year-old man who was 2 years and 11 months post-bone marrow transplantation (BMT) for leukemia. Prior to the TFI, the patient had flashbacks to BMT and reported physical sensations such as sweating and chills triggered by reminders of this treatment. A preintervention diagnosis of PTSD was confirmed using the Structured Clinical Interview for DSM-IV (SCID). After 10 TFI sessions including general and cancer PMT-specific information about PTSD, relaxation training, cognitive coping strategies, systematic desensitization, and relapse prevention, the patient no longer had a PTSD diagnosis. At 6-month follow-up, improvements were maintained, confirmed by the SCID. Using statistical analysis for a single case design, TFI was also found to significantly decrease distress and PTSD symptoms on self-report measures (as indicated with the Brief Symptom Inventory and Posttraumatic Stress Disorder Checklist-Civilian), and to improve quality of life (Medical Outcome Survey). Results are discussed in terms of this specific cognitive-behavioral treatment for BMT survivors with PTSD and the relevance of such interventions in the oncology treatment setting, where the possibility of retraumatization is a realistic patient concern.