Clients' Experiences of Returning to the Trauma Site during PTSD Treatment: An Exploratory Study

BACKGROUND: Visits to the location of the trauma are often included in trauma-focused cognitive behavioural therapy (TF-CBT) for post-traumatic stress disorder (PTSD), but no research to date has explored how service users experience these visits, or whether and how they form an effective part of treatment.

AIMS: The study aimed to ascertain whether participants found site visits helpful, to test whether the functions of the site visit predicted by cognitive theories of PTSD were endorsed, and to create a grounded theory model of how site visits are experienced.

METHOD: Feedback was collected from 25 participants who had revisited the scene of the trauma as part of TF-CBT for PTSD. The questionnaire included both free text items, for qualitative analysis, and forced-choice questions regarding hypothesized functions of the site visit.

RESULTS: Overall, participants found the site visits helpful, and endorsed the functions predicted by the cognitive model. A model derived from the feedback illustrated four main processes occurring during the site visit: "facing and overcoming fear"; "filling in the gaps"; "learning from experiences" and "different look and feel to the site", which, when conducted with "help and support", usually from the therapist, led to a sense of "closure and moving on".

CONCLUSIONS: Therapist-accompanied site visits may have various useful therapeutic functions and participants experience them positively.