Abstract
This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ainsworth, M. D. S. (1969). Object Relations, dependency, and attachment: A theoretical review of the infant-mother relationship. Child Development, 40, 969–1025.
Alexander, F. F., & French, T. M. (1946). Psychoanalytic therapy; principles and application. Oxford England: Ronald Press.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Asner-Self, K. K., Schreiber, J. B., & Marotta, S. A. (2006). A cross cultural analysis of the Brief Symptom Inventory-18. Cultural Diversity and Ethnic Minority Psychology, 12(2), 367–375.
Basharpoor, S., Narimani, M., Gamari-give, H., Abolgasemi, A., & Molavi, P. (2011). Effect of cognitive processing therapy and holographic reprocessing on reduction of posttraumatic cognitions in students exposed to trauma. Iran Journal of Psychiatry, 6(4), 138–144.
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric properties of the PTSD checklist (PCL). Journal of Behaviour Research and Therapy, 8, 669–673.
Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. New York: Basic Books.
Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. New York: Basic Books.
Derogatis, L. R. (2000). The Brief Symptom Inventory. Bloomington: Pearson.
Epstein, S. (1998). Cognitive-experiential self-theory. Advanced Personality (pp. 211–238). New York: Plenum.
Foa, E. B., Hembree, E. A., & Rothbaum, B. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences: Therapist guide. New York: Oxford University.
Foa, E. B., & Rauch, S. A. (2004). Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 72(5), 879–884.
Foa, E. B., & Rothbaum, B. O. (1998). Treating the trauma of rape: A cognitive-behavioral therapy for PTSD. New York: Guilford Press.
Foa, E. B., Rothbaum, B. O., & Furr, J. M. (2003). Augmenting exposure therapy with other CBT procedures. Psychiatric Annals, 33(1), 47–53.
Foa, E. B., Tolin, D., Ehlers, A., Clark, D., & Orsillo, S. (1999). The posttraumatic cognitions inventory: Development and validation. Psychological Assessment, 11(3), 303–314.
Garcia, H. A., Kelley, L. P., Rentz, T. O., & Lee, S. (2011). Pretreatment predictors of dropout from cognitive behavioral therapy for PTSD in Iraq and Afghanistan war veterans. Psychological Services, 8(1), 1–11.
Gendlin, E. T. (1996). Focusing-oriented psychotherapy: A manual of the experiential method. New York: Guilford Press.
Goldzweig, C. L., Balekian, T. M., Rolon, C., Yano, E. M., & Shekelle, P. G. (2006). The state of women veterans’ health research: Results of a systematic literature review. Journal of General Internal Medicine, 21(3), 82–92.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.
Katz, L. (2001). Holographic reprocessing: A cognitive-experiential psychotherapy for the treatment of trauma. Psychotherapy: Theory, Research, Practice, and Training, 38(2), 186–197.
Katz, L. (2005). Holographic reprocessing: A cognitive-experiential psychotherapy for the treatment of trauma. New York: Brunner-Routledge.
Katz, L., Snetter, M., Hagler, A., Hewitt, P., & Cojucar, G. (2008). Holographic Reprocessing: Empirical evidence to reduce posttraumatic cognitions in women Veterans with PTSD from sexual trauma and abuse. Psychotherapy: Theory, Research, Practice, and Training, 45(2), 186–198.
Kelly, U. A., Skelton, K., Patel, M., & Bradley, B. (2011). More than military sexual trauma: Interpersonal violence, PTSD, and mental health in women Veterans. Research in Nursing and Health, 34(6), 457–467.
Main, M., & Solomon, J. (1986). Discovery of an insecure-disorganized/disoriented attachment pattern. In T. B. Brazelton & M. W. Yogman (Eds.), Affective development in infancy (pp. 95–124). Westport, CT: Ablex Publishing.
McIsaac, H. K., & Eich, E. (2002). Vantage point in episodic memory. Psychonomic Bulletin and Review, 9, 146–150.
McIsaac, H. K., & Eich, E. (2004). Vantage point in traumatic memory. Psychological Science, 15(4), 248–253.
Resick, P., Nishith, P., Weaver, T., Astin, M., & Feurer, C. (2002). A comparison of cognitive processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70(4), 867–879.
Resick, P. A., & Schnicke, M. K. (1996). Cognitive processing therapy for rape victims: A treatment manual. Newbury Park: Sage.
Rogers, C. R. (1963). The actualizing tendency in relation to “motives” and to consciousness. In Marshall Jones (Ed.), Nebraska Symposium on Motivation (pp. 1–24). Nebraska: Univ. of Nebraska Press.
Rogers, C. R. (1978). The Formative Tendency. Journal of Humanistic Psychology, 18(1), 23–26.
Rothbaum, B. O., Astin, M. C., & Marssteller, F. (2005). Prolonged exposure versus eye movement desensitization and reprocessing (EMDR) for PTSD rape victims. Journal of Traumatic Stress, 18(6), 607–616.
Schnurr, P. P., Friedman, M. J., Engel, C. C., Foa, E. B., Shea, T., Chow, B. K., et al. (2007). Cognitive behavioral therapy for posttraumatic stress disorder in women: A randomized controlled trial. Journal of the American Medical Association, 297(8), 820–830.
Schnurr, P. P., Friedman, M. J., Foy, D. W., Shea, M. T., Hsieh, F. Y., & Lavori, P. W. (2003). Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: Results from a department of Veterans affairs cooperative study. Archives of General Psychiatry, 60(5), 481–489.
Smucker, M., & Dancu, C. (1999). Cognitive behavioral treatment for adult survivors of childhood abuse: Imaginal rescripting and reprocessing. Northvale: Aronson.
Suris, A., & Lind, L. (2008). Military sexual trauma: A review of prevalence and associated health consequences in veterans. Trauma, Violence, and Abuse, 9(4), 250–269.
Wachtel, P. L., & McKinney, M. K. (1992). Cyclical psychodynamics and integrative psychodynamic therapy. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 335–370). New York: Basic Books.
Wallin, D. J. (2007). Attachment in Psychotherapy. New York: Guilford Publications.
Weathers, F.W., Litz, B.T., Herman, D.S., Huska, J.A., Keane T.M. (1993, October). The PTSD checklist: reliability, validity, & diagnostic utility. Paper presented at the Annual Meeting of the International Society for Traumatic Stress Studies San Antonio, TX.
White, M. (2007). Maps of narrative practice. New York: WW Norton.
Young, J.E. (1990, 1999). Cognitive therapy for personality disorders: A schema-focused approach (revised edition). Professional Resource Exchange.
Zayfert, C., DeViva, J. C., Becker, C. B., Pike, J. L., Gillock, K. L., & Hayes, S. A. (2005). Exposure utilization and completion of cognitive behavioral therapy for PTSD in a “real world” clinical practice. Journal of Traumatic Stress, 18(6), 637–645.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Katz, L.S., Douglas, S., Zaleski, K. et al. Comparing Holographic Reprocessing and Prolonged Exposure for Women Veterans with Sexual Trauma: A Pilot Randomized Trial. J Contemp Psychother 44, 9–19 (2014). https://doi.org/10.1007/s10879-013-9248-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10879-013-9248-6