In this study, an attempt was made to evaluate changes in the self-image of traumatized refugees receiving short-term psychotherapy. Fourteen clients with war and torture experiences were followed during and after trauma-focused therapies with self-rating instruments. Outcome was measured with SCL-90, measuring overall psychiatric symptoms, and with PTSS-10, measuring Post-traumatic Stress Disorder (PTSD) symptoms. Self-image was measured with Structural Analysis of Social Behavior (SASB). The analyses showed considerable remission of both general psychiatric and PTSD-related symptoms, but more moderate changes in self-image aspects. The positive aspect of the self-image was virtually non-related to the symptom measures and did not change after the termination of the therapy; the negative aspect of the self-image was more strongly related to the symptoms and changed mainly on the last measurement occasion, 15 months after the therapy end. When clients with good and poor outcome were compared, it was found that those with good outcome had higher initial levels on both the positive and the negative aspects of the self-images. This was tentatively interpreted as indicating that clients who had invested more energy in their self-image were better able to utilize the therapy. Different development in the self-image for these two groups indicated that for some clients, the treatment process might have entailed too much strain.

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refugee follow up human war priority journal interview psychotherapy remission Treatment Outcome male female psychological rating scale short course therapy clinical article self concept symptom scoring system Article adult posttraumatic stress disorder psychotrauma