(Philadelphia, PA) - Edna B. Foa, PhD, Professor of Psychology in Psychiatry at the University of Pennsylvania School of Medicine, will conduct training on responding to post-traumatic stress disorder (PTSD) for a group of nine mental health professionals from the region affected by the tsunami of December 2004. The training will take place from October 5 to October 18, 2005 at the Penn School of Medicine.

Five psychiatrists from Indonesia and four psychologists from Thailand will participate in the program. Upon completion, they will provide training to other mental health professionals in their respective countries to help those suffering from PTSD following the tsunami.

The Penn course of “training the trainers” grew out of a post-tsunami conference for mental health practitioners held in Bangkok, Thailand this past February at which Foa was a presenter. PTSD is an extremely debilitating and chronic condition that often follows a terrifying physical and emotional event. The PTSD sufferer experiences persistent, frightening thoughts and memories, nightmares or flashbacks, of the traumatic event, as well as a host of other debilitating symptoms.

“We know that three months after a traumatic event, recovery rates slow down,” explains Foa. “Usually after a year, if severe symptoms are not treated, they become chronic, and natural recovery is unlikely to happen. Since the tsunami occurred nine months ago, people still suffering from PTSD are likely to need some intervention to alleviate their symptoms and prevent persistent problems.”

The Penn training will center on prolonged exposure therapy, which was developed by Foa. It has been widely used and studied in many treatment centers. The Thai and Indonesian educators will first be taught how to conduct prolonged exposure therapy themselves. This includes teaching patients breathing exercises that will help them relax. They will also be taught the importance of providing patients with psychoeducation about the symptoms of PTSD, why some people recover and others do not, and why exposure therapy reduces PTSD symptoms. They will also learn to teach their colleagues prolonged exposure therapy.

“The therapists educate the patients about common reactions to trauma so that they don't feel that something is wrong with them because they are having these symptoms,” says Foa. “Some of the symptoms -- like the flashbacks, where a person actually feels as if he is in the middle of the trauma again -- can be very scary, and give the sense of going crazy. So educating patients is very helpful in the sense that it gives them a way to understand their symptoms and put them in perspective.

The Penn participants will also be taught the importance of asking patients to think about the trauma and describe it in detail. If people show symptoms of PTSD, it is an indication that the traumatic memory has not been processed in a way that allows patients to acknowledge the horrible nature of their experience while recognizing that it is in the past, and that they can and need to resume their lives.

Foa noted, “In exposure therapy, patients invoke the memory and describe it again and again. These repetitions provide opportunities to gain perspective, to realize that patients are describing a past experience, and that thinking about the trauma is not the same as being in the trauma. These exercises should be part of every session. This will be a key theme of the training we will be providing at Penn.”

The Penn training will also highlight another goal of prolonged exposure: to help patients deal with situations that they avoid because they remind them of the traumatic event, such as going to the beach or being in crowded places. For some people the fear is so severe that they do not leave their homes; other people stopped watching television, reading newspapers, or going to movies because they are afraid that there will be a story that will remind them of the traumatic event and its aftermath.

In this part of the treatment, therapists help patients identify situations that they avoid and that are important for them to confront in order to function. The therapist creates a hierarchy of these situations and asks the patient to initially confront those that are not as anxiety evoking. Gradually, the patient ascends the hierarchy and confronts situations that are more and more anxiety evoking.

The overall treatment involves between eight to fifteen sessions. Foa and other researchers have found that prolonged exposure therapy helped at least 85 percent improve, and 50 percent of the patients improve so much that they achieved a remission.

Foa is also Director of the Center for the Treatment and Study of Anxiety at Penn and is an internationally renowned authority on the psychopathology and treatment of anxiety. She is one of the leading experts in the areas of post-traumatic stress disorders. She has published several books and over 250 articles and book chapters, has lectured extensively around the world, and is the recipient of numerous awards and honors.

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