loading page

Trauma History and Course of Therapy in a Naturalistic Cognitive Behavior Therapy Outpatient Sample: An Archive Data Study
  • +1
  • Franziska Epe-Jungeblodt,
  • Paul Pauli,
  • Frank Schwab,
  • Marta Andreatta
Franziska Epe-Jungeblodt
Julius-Maximilians-Universitat Wurzburg Institut fur Psychologie

Corresponding Author:[email protected]

Author Profile
Paul Pauli
Julius-Maximilians-Universitat Wurzburg Institut fur Psychologie
Author Profile
Frank Schwab
Julius-Maximilians-Universitat Wurzburg Fakultat fur Humanwissenschaften
Author Profile
Marta Andreatta
Universitatsklinikum Tubingen Universitatsklinik fur Psychiatrie und Psychotherapie
Author Profile


Objective: Cognitive Behavior Therapy (CBT) is an effective treatment for anxiety and depression disorders. Nonetheless, nearly 50% of all patients do not respond. Besides other factors, this seems to be linked to the experience of traumatic life events. This study aims to assess the effects of trauma history on the choice of therapy interventions and treatment outcomes. Methods: We analyzed data from 340 CBT outpatients diagnosed with a depression or anxiety disorder and possibly a trauma history treated under naturalistic conditions. Based on their written therapy files, we collected information on trauma history, psychiatric diagnoses, duration of therapy, applied interventions, and severity of depression and anxiety symptoms at the start and end of therapy. The influence of trauma, diagnoses, and intervention use on the development of depression and anxiety symptoms were analyzed. Results: Patients with a trauma history reported higher overall depression and anxiety symptoms than those without trauma. No differences in the duration of therapy, applied interventions, or decrease in symptom severity were found between patients with and without a trauma history. Trauma-specific interventions failed to boost treatment success; however, they were also seldom applied. Conclusion: Although no differences between traumatized and non-traumatized patients were found for naturalistic CBT, traumatized patients maintained higher levels of symptom severity irrespective of diagnoses. These results indicate a need for more trauma-specific and personalized interventions. Therapists may need evidence-based guidelines to personalize CBT for patients with a trauma history and high symptom severity.
07 Nov 2023Submitted to Journal of Clinical Psychology
08 Nov 2023Assigned to Editor
08 Nov 2023Submission Checks Completed
17 Nov 2023Review(s) Completed, Editorial Evaluation Pending
21 Nov 2023Reviewer(s) Assigned