Behavioural Treatments For PTSD
Prolonged exposure is a manual-guided CBT comprising ten, sixty-to-ninety-minute weekly individual therapy sessions. We can explain the central therapeutic component of prolonged exposure on "Pavlovian learning theory."
The treatment involves repeatedly presenting a conditioned stimulus (e.g., a trauma reminder) in the absence of an unconditioned stimulus (e.g., the traumatic event). They do this through imaginal exposure during therapy sessions and through in vivo exposure in the environment.
On average, prolonged exposure proves robust symptom severity improvement.
Another manual-guided cognitive behavioural modality that has received strong empirical support to treat PTSD is cognitive processing therapy.
Cognitive processing therapy comprises twelve weekly, 60-minute individual sessions.
This therapy involves
- Imagining and reviewing written narratives
- these depict the thoughts and emotions about the traumatic event.
- Participants receive homework assignments
- Designed to identify and challenge the maladaptive thought patterns that maintain the symptoms.
Modified Group-Therapy Cognitive Therapy
A modified group-therapy version of cognitive processing therapy has promising results.
Evidence also supports the effectiveness of cognitive-only cognitive processing therapy.
- Cognitive skill-building
- Cognitive restructuring skills.
The cognitive-only therapy does not employ written narratives, and the most recent treatment manual recommends cognitive-only therapy as the first-line version, with written narratives as an optional modification.
Eye Movement Desensitization and Reprocessing
Eye movement desensitisation and reprocessing is one of the three most-studied treatments for PTSD.
This therapy incorporates a variety of techniques, including prolonged exposure and cognitive restructuring, but it differs in that it applies these techniques in conjunction with guided eye movement exercises.
Narrative exposure therapy is a manual-guided psychotherapy developed to treat PTSD among individuals seeking asylum from political or organized violence.
In this technique, which also includes psychoeducation about PTSD, participants narrate their relevant developmental memories in chronological order and narrate details of their trauma exposures as they were experienced over time. Typically, the sessions are 60 to 120 minutes, once a week for 4 to 10 weeks.
Present-centered therapy is a time-limited intervention that includes a psychoeducation component, skill development to manage daily stressors and challenges, and homework to solidify the new skills developed in sessions., This therapy has demonstrated efficacy in a variety of populations and is commonly used in randomized controlled trials as a comparator for new or adapted PTSD treatments.
Cognitive Behavioral Conjoint Therapy
Cognitive behavioral conjoint therapy for PTSD is a manual-guided, 15-session CBT. This intervention is designed to improve PTSD symptoms and relationships at the same time.
Research in this area is critical, as dyadic distress and dysfunction are saliently associated with poor individual PTSD treatment outcomes.
Cognitive behavioral conjoint therapy involves psychoeducation on PTSD and relationships, learning communication skills to address avoidance related to PTSD and relationship problems, and challenging trauma-related beliefs.
The empirical literature on other interventions is limited, but the research shows promising findings. These integrate cognitive behavioral and other therapeutic approaches.
• Emotion-focused therapy
• Brief eclectic psychotherapy.