An Israeli clinical psychologist who teaches at the University of Pennsylvania and is a leader in treating post-traumatic stress disorder (PTSD) has just been selected by Time magazine as one of 100 of the most influential people in the world.
Prof. Edna Foa, who was born in Haifa, studied at Bar-Ilan University and still visits Israel and stays in her Tel Aviv apartment twice a year, is being cited for her therapy, called Prolonged Exposure Therapy, a prolonged exposure to cognitive behavioral therapy (CBT).
In this treatment, patients are exposed to imagery of their traumatic memories, as well as real-life situations related to the traumatic event in a step-by-step, controlled way. Through these exposures, the individual learns to confront the trauma and begin to think differently about it, leading to a marked decrease in levels of anxiety and other PTSD symptoms.
The therapy has been scientifically tested in adults and children who have experienced trauma – from war and terror to road accidents and abuse – years and even decades after it occurred.
“She has given it to soldiers from the Yom Kippur War in 1973 as well, and it certainly has helped, but we can’t yet claim efficacy for such patients, or those who survived the Holocaust, for example,” said Sheba Medical Center psychiatrist Dr. Nitsa Nacasch, who studied the technique with Foa in the US and brought it to Israel.
She said it eliminated traumatic symptoms from nightmares and loss of appetite to flashbacks, and told The Jerusalem Post
that in patients who have been followed up for two years or more the treatment was found to minimize or eliminate PTSD symptoms in 80 percent of cases. The symptoms themselves were found to have been reduced by 40% or more, she added.
Nacasch went to the University of Pennsylvania for five weeks in 2002, during the height of the second intifada, to learn the technique in order to help her PTSD patients. She has taught hundreds of Israeli therapists, and the treatment is available at Sheba at Tel Hashomer, as well as at Hadassah University Medical Center in Jerusalem, Emek Medical Center in Afula, Rambam Medical Center in Haifa and Barzilai Medical Center in Ashkelon as well.
The US Department of Defense and the Canadian military authorities have been so impressed by Foa’s therapy that they’ve asked her to train psychologists and other professionals who work with PTSD victims who have survived war and terror.
Nacasch said she had spoken to Foa since Time
made its announcement but could not quote her. Foa plans to visit Israel again and do more teaching sessions next month.
“There are all types of treatment protocols for CBT, in which victims are exposed gradually to the thing that causes them anxiety and fear, but this one is rigid and very specific,” Nacasch said.
“Edna’s great work in the past decade has been dissemination of the technique to as many people as she could reach,” her friend added.
Foa developed a different CBT protocol for obsession-compulsion disorder and other psychological problems.
The therapy is given individually, not in groups, with the treatment suited to each individual case consisting of from four up to 15 sessions of 90 minutes each, said Nacasch.
“Hundreds of Israelis have undergone it,” she said.
She said that it had shown itself to be “at least as effective as [psychotropic] medications.”
Foa is director of the Center for the Treatment and Study of Anxiety at her university. She received her BA in psychology and literature from Bar-Ilan and her doctorate in clinical psychology and personality from University of Missouri.
On the basis of Foa’s empirical studies to evaluate its efficacy, many professionals have adopted Prolonged Exposure as the treatment of choice for PTSD. Over the past few years, the numbers of Americans and other nationals around the world suffering from PTSD has increased dramatically as a result of increased terror attacks and the wars in Iraq and Afghanistan. This increase resulted in an urgent need to disseminate the treatment to mental health professionals. Foa has invested much time training professionals at the US Veterans Administration hospitals and clinics.
Foa has published several books and over 350 articles and book
chapters, and has lectured extensively around the world. She has
received numerous awards and honors.
She was chairman of the DSM-IV (“bible of psychiatric disorders”)
subcommittee for OCD and co-chairs the DSM-IV Subcommittee for PTSD.
Prof. Arieh Shalev, chief of psychiatry at Hadassah University Medical Center in Jerusalem’s Ein Kerem, told the Post
that he has known Foa for many years and has supervised the testing of
her technique and found it effective in many PTSD victims.
“It works very well for them. We didn’t test it decades after exposure
to trauma, and I think it works best when many years have not passed
since the event.”
In 1996, Shalev’s team wrote an article summary on PTSD and declared
that none of the things available then worked, “so we were glad to have
found since then that Edna’s protocol can be effective.”
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