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Les psychothérapies individuelles indiquées dans les troubles psychiques post-traumatiques de guerre : analyse des recommandations françaises et américaines

Abstract : Background-The psychotherapeutic treatment of war-related psychological injuries is questioned because of its theoretical level of complexity as well as its non-consensual or controversial guidelines. The care provided by civilian and military networks is diverse, heterogeneous and given more and more media coverage. How can the military patients' and of their relatives' pressing demands for the many techniques deemed advisable in the treatment of post-traumatic stress disorder be addressed? Material and methods-We present three individual psychotherapeutic approaches most frequently proposed in the field of psychotraumatology: cognitive and behavioural therapies, Eye Movement Desensitization and Reprocessing, and psychodynamic psychoanalytic orientation. We propose an analysis of the French and American recommendations before confronting the guidelines to the reality of clinical practice. Discussion-Each of the varied psychotherapies yields theoretical and technical arguments. Nevertheless, it seems impossible to discriminate between them in terms of efficiency in the current state of scientific research. The experienced clinicians must be cautious when they deal with the recommendations based on comparisons, in areas where the patients' singularity and the transference relationship are difficult to model. Conclusion-To propose a project of custom-made care to suffering fighters entails to focus on a rigorous clinical analysis. The coordination and continuity of medical and psychological support are essential. Beyond dogmatism, we shall select the following motto: 'the right psychotherapy, for the right patient at the right time'.
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Yann Auxemery, Benoit Favodon, Marie-Dominique Colas. Les psychothérapies individuelles indiquées dans les troubles psychiques post-traumatiques de guerre : analyse des recommandations françaises et américaines. Médecine et Armées, Service de santé des armées, 2018, Médecine des voyages, 46 (1), pp.91-96. ⟨hal-02950385⟩

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