![]() The greatest number of studies have been conducted on exposure-based treatments, which involve having survivors repeatedly think about or re-tell their traumatic event. Trauma-focused psychotherapies with the strongest evidence There are other psychotherapies that meet the definition of trauma-focused treatment for which there is currently weak or insufficient evidence to recommend for or against their use (1). Furthermore, these treatments have been validated by research teams other than the developers. These treatments have been tested in numerous clinical trials, in patients with complex presentations and comorbidities, in comparison to active control conditions, and with long-term follow-up designs. The trauma-focused psychotherapies with the strongest evidence from clinical trials are PE, CPT, and EMDR (7-15). ![]() The CPG defines trauma-focused psychotherapy as therapy that uses cognitive, emotional, or behavioral techniques to facilitate processing a traumatic event and in which the trauma focus is a central component of the therapeutic process (4). Results of meta-analyses suggest that either one can reduce PTSD symptoms (2-4).īack to Top Trauma-Focused Psychotherapies ![]() There are no data to guide whether medication or non-trauma-focused psychotherapy is more effective in cases where trauma-focused psychotherapy is unavailable or not desired. In such cases, the CPG recommends certain individual, manualized psychotherapies (specifically, Cognitive Therapy (6), Written Exposure Therapy, and Present Centered Therapy see below) or using medication (specifically, sertraline, paroxetine or venlafaxine see Clinician's Guide to Medications for PTSD). Individual trauma-focused psychotherapies may not be available in all settings and not all patients choose to engage in these treatments. However, in that study medication management was more extensive than typical medication management (5). A notable exception was a recent randomized controlled trial (RCT) that compared PE to sertraline and the combination (PE + sertraline) and found no differences. In addition, the risks for negative side effects or negative reactions are generally greater with medication than with psychotherapy. Restricting the studies to the subset that included active controls did not change the results. ![]() Two prior meta-analyses that compared the treatment effects of psychotherapies and pharmacotherapies (3,4) also showed that trauma-focused psychotherapies lead to greater improvement in PTSD symptoms than medications, and that these improvements last longer. Although there have been few direct head-to-head comparisons of trauma-focused psychotherapy and a first-line medication for treating PTSD, a recent meta-analysis by Merz and colleagues (2019) examined comparative effectiveness studies and concluded there was greater benefit of psychological treatments (2). The VA/DoD CPG (2023) recommends treating PTSD using individual trauma-focused psychotherapy (specifically PE, CPT, EMDR) over medications based on the current state of the PTSD treatment research (1). Individual Trauma-Focused Psychotherapy Recommended Over Other Treatments for PTSD Trauma-Focused Psychotherapies Other Psychotherapies With Sufficient Evidence to Recommend for the Treatment of PTSD Therapies With Insufficient Evidence to Recommend for the Treatment of PTSD Adding or Removing Components of Evidence-Based Treatments Is Not Recommended Conclusion References Individual Trauma-Focused Psychotherapy Recommended Over Other Treatments for PTSD
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3/28/2024 01:05:54 am
At The Well Woman, one of our main treatment approaches when working with individuals is Cognitive Behavior Therapy (CBT). CBT was developed by psychiatrist Aaron Beck, MD in the early 1960’s. Cognitive Behavior Therapy is popular among mental health professionals, as it is evidence-based. Currently, more than 500 outcome studies have demonstrated the efficacy of CBT for a wide range of psychiatric disorders, psychological problems, and medical problems with psychological components (Butler, Chapman, Forman, Beck, 2006; Chambless; Ollendeck, 2001). In a nutshell, the CBT model proposes that dysfunctional thinking, which influences our mood and behavior, is common to all psychological disturbances.
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