Australian Psychotherapy for Trauma Incorporating Neuroscience: Evidence- and Ethics-Informed Practice
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Abstract
Currently there are several psychotherapy modalities utilising theory and research from neuroscience in treatment frameworks for mental health and recovery from trauma. In Australia this includes: (i) the Conversational Model of Psychodynamic Psychotherapy, a contemporary psychodynamic approach used for treating Borderline Personality Disorder and other trauma-related disorders; (ii) Electroencephalogram Neurofeedback, a brain training therapy which has been used as an adjunct to counselling/psychotherapy in traumatic stress and developmental trauma; and (iii) Somatic Experiencing, an integrative mind-body approach based on body responses to threat and fear, especially thwarted attempts to enact fight or flight in the face of threat. These modalities have a promising but still-limited evidence base. This paper explores the role of different types of evidence to frame a descriptive review of the current evidence base available for clinicians practicing in these three modalities. While large clinical trials can provide evidence of comparative effectiveness, case studies, observational, qualitative and practice-based enquiry can assist in discovering other aspects of therapy important for individual clients and practitioners. Existing frameworks of evidence- and ethics-informed health and clinical decision-making suggest an ethical approach can incorporate new, developing and evidence-building therapies. Recommendations include careful consideration of informed consent for therapy including disclosure of efficacy and safety, and specific to psychotherapies incorporating neuroscience, a need for practitioners to reflectively assess their own knowledge, competence, heuristic approaches and biases.
Keywords
Neuroethics Evidence-based practice Practice-based evidence Conversational Model Therapy Neurofeedback Somatic ExperiencingNotes
Author Contributions
All authors have agreed on the final version and made substantial contributions to the conception, drafting and revision of the document.
Compliance with Ethical Standards
Conflict of Interest
Associate Professor Loyola McLean is the holder of a Northern Sydney Local Health District/Ramsay Teaching and Research Grant: The implementation and evaluation of a trauma specific short-term Conversational Model Intervention for clients of the Northern Sydney Sexual Assault Service: team skill-building, culture change and fostering recovery.
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