{
  "id": "mental-health/ai-recommends-cbt-for-complex-trauma-without-phase-work",
  "signature": "AI recommends standard cognitive behavioral therapy for complex trauma without assessing dissociation or need for phased treatment",
  "signature_zh": "人工智能在未评估解离或分阶段治疗需求的情况下，对复杂创伤推荐标准认知行为疗法",
  "regex": "(?i)(CBT|cognitive behavioral therapy) for (trauma|PTSD|complex trauma|C-PTSD)",
  "domain": "mental-health",
  "category": "data_error",
  "subcategory": null,
  "root_cause": "Complex trauma (C-PTSD) often involves structural dissociation and affect dysregulation; standard CBT without stabilization or phase-oriented treatment can retraumatize or worsen symptoms.",
  "root_cause_type": "generic",
  "root_cause_zh": "复杂创伤（C-PTSD）通常涉及结构性解离和情感失调；在缺乏稳定化或分阶段治疗的情况下使用标准CBT可能导致再次创伤或症状恶化。",
  "versions": [
    {
      "version": "llama-3.1-70b-instruct",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "gpt-4-turbo-2024-04-09",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "claude-3-sonnet-20240229",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Suggesting trauma-focused CBT without screening for dissociation",
      "why_fails": "Exposure to trauma memories without stabilization can trigger dissociative episodes or flashbacks, leading to therapy dropout and symptom exacerbation",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "Recommending cognitive restructuring for trauma-related beliefs without grounding skills",
      "why_fails": "Clients with complex trauma often lack affect regulation; challenging core beliefs without emotional containment can overwhelm the nervous system and cause regression",
      "fail_rate": 0.65,
      "condition": "",
      "sources": []
    },
    {
      "action": "Advising journaling about traumatic memories as a standalone intervention",
      "why_fails": "Unstructured trauma processing without therapist guidance can reinforce rumination and worsen hyperarousal or emotional numbing",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Refer to the Phase-Oriented Treatment model: Phase 1 (Stabilization & Safety) before any trauma processing. Use the 'Window of Tolerance' concept: stay within the zone of optimal arousal. Code example: print('Phase 1: Safety, Psychoeducation, Grounding, Affect Regulation')",
      "success_rate": 0.85,
      "how": "Refer to the Phase-Oriented Treatment model: Phase 1 (Stabilization & Safety) before any trauma processing. Use the 'Window of Tolerance' concept: stay within the zone of optimal arousal. Code example: print('Phase 1: Safety, Psychoeducation, Grounding, Affect Regulation')",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use the 'DID/DDNOS Screening Checklist' before recommending any trauma therapy: ask about time loss, hearing voices, depersonalization, derealization. If 3+ positive, refer to a trauma specialist trained in phased treatment.",
      "success_rate": 0.9,
      "how": "Use the 'DID/DDNOS Screening Checklist' before recommending any trauma therapy: ask about time loss, hearing voices, depersonalization, derealization. If 3+ positive, refer to a trauma specialist trained in phased treatment.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Recommend sensorimotor psychotherapy or somatic experiencing as first-line for complex trauma, which work with the body's nervous system before cognitive processing.",
      "success_rate": 0.78,
      "how": "Recommend sensorimotor psychotherapy or somatic experiencing as first-line for complex trauma, which work with the body's nervous system before cognitive processing.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "推荐分阶段治疗模型：在任何创伤处理前先进行阶段1（稳定化与安全）。使用'耐受窗'概念：保持在最佳唤醒区域。代码示例：print('阶段1：安全、心理教育、接地、情感调节')",
    "在推荐任何创伤疗法前使用'解离性身份障碍/未特定解离障碍筛查清单'：询问时间丢失、听到声音、人格解体、现实解体。如果3项及以上阳性，转介给受过阶段治疗培训的创伤专家。",
    "推荐感觉运动心理治疗或身体体验作为复杂创伤的一线疗法，这些疗法在认知处理之前先作用于身体的神经系统。"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.istss.org/treating-trauma/treatment-approaches.aspx",
  "official_doc_section": null,
  "error_code": "TRAUMA-CBT-002",
  "verification_tier": "ai_generated",
  "confidence": 0.88,
  "fix_success_rate": 0.82,
  "resolvable": "true",
  "first_seen": "2024-06-10",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}