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Kratzer, Leonhard; Heinz, Peter; Pfitzer, Franz; Schennach, Rebecca; Aichhorn, Wolfgang; Aas, Benjamin; Schiepek, Gunter (2018): Real-Time-Monitoring in der Behandlung komplexer posttraumatischer Belastungsstörung: Ein Fallbericht. In: Verhaltenstherapie, Vol. 28, No. 2: pp. 93-99
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Background: This case report shall demonstrate the feasibility and usefulness of real-time monitoring of change dynamics in the trauma-focused inpatient treatment of a client presenting with complex posttraumatic stress disorder (PTSD). Patient and Methods: Case conceptualization and treatment were based on an inpatient treatment program for adults with complex trauma and followed recommendations regarding the trauma-focused treatment for patients with pathological narcissism. The change process was monitored using an Internet-based real-time monitoring tool (Synergetic Navigation System) and repeatedly reflected on by therapist and client in therapeutic feedback sessions. Results: The real-time monitoring facilitated the therapeutic process. In particular, it allowed for repeatedly reflecting on the patient's specific affective dynamics regarding shame, anger, guilt, and self-esteem, and on the changes of these dynamics following the processing of traumatic memories in therapeutic feedback sessions. Not only did the patient develop new self-care patterns and improve his emotion regulation capabilities, he also remitted from PTSD, depression, somatoform symptoms, interpersonal problems, and deficits in self-efficacy and psychological well-being. Conclusions: In this case, the multimodal trauma-focused treatment was effective in reducing the symptoms of complex PTSD and comorbid personality disorder. Real-time monitoring allows for the identification and treatment of a patient's key affective dynamics, rendering the treatment of patients with complex PTSD and personality disorders more effective.