This paper described the application and feasibility of exposure therapy treatment (ET) for posttraumatic stress disorder (PTSD) in a multitraumatized tortured refugee with chronic PTSD and depression, in need of an interpreter. The patient received 26 one-hour sessions of ET involving exposure to his trauma-related memories. Symptoms of PTSD, depression, and anxiety were assessed at pre- and posttreatment and 3-, 6-, and 12-month followup with the Harvard Trauma Questionnaire (HTQ-R), PTSD Symptom Scale-Self Report (PSS-SR), Major depression inventory (MDI), and Beck Anxiety Inventory (BAI). Treatment led to a significant improvement across all measures of posttraumatic stress disorder, anxiety, and depression, and the improvement was maintained at the 12-month follow-up. The results from this case study provide further preliminary evidence that ET may be effective in treating multi-traumatized torture survivors who are refugees and in need of an interpreter, despite the additional stressors and symptoms complexity experienced by tortured refugees. 1. Introduction PTSD is a highly prevalent, often chronic, and invalidating psychiatric disorder that can develop following exposure to a traumatic event. It is a condition resulting from exposure to a life threatening event that is processed in such a way that the experience produces a sense of a current threat and two broad sets of negative cognitions, “The world is entirely dangerous” and “I am completely incompetent to cope with it” [1, 2]. This leads to the experiencing of symptoms that fall into three clusters and define PTSD according to the diagnostic systems in DSM-IV-TR and ICD-10: intrusive symptoms, avoidance symptoms, and symptoms of hyperarousal [3, 4]. Among refugees it is estimated that approximately 3% to 86% of the population suffers from PTSD, depending upon the type of sample, the type of traumatic events, and the refugee groups that were studied [5]. In 2001, The Danish Ministry of Health estimated that at least 50,000 refugees in Denmark suffered from PTSD and/or depression and that 5 to 44% of them are estimated to have a history of torture [6]. In 2008, the Amnesty International Danish Medical Group published a report based on medical examinations of 142 newly arrived asylum seekers in Denmark. Of the newly arrived asylum seekers, 45% said that they had been tortured. The psychological symptoms were approximately three times as frequent among torture survivors as among nontortured asylum seekers. Among torture survivors 63% met the criteria for PTSD, with the study suggesting that
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