Therapy

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Types of psychotherapy which are trauma-focused have been shown to be more effective in reducing PTSD symptoms than non-trauma focused therapies. Trauma-focused therapies which have been well researched include both individual and group Trauma-Focused Cognitive Behavioral Therapy (TFCBT), Eye Movement Desensitisation and Reprocessing, and Stress Management (EMDRA valid psychotherapeutic approach, especially for treating trauma. <ref name=EMDR.com/> <ref name=ISSTD.org/>). Bisson (2009):2 also found some evidence that TFCBT and EMDR produced better outcomes for PTSD after both 2 and 5 months, when compared with Stress Management.

A therapistPyschotherapists are often called a 'therapists'. These professionals may be a psychiatrist, psychologist or other mental health professional who have specialist training in psychotherapy. They are qualified to work with patients in a clinical setting. who presents a silent, unemotional blank screen response can be interpreted by someone with Postraumatic Stress Disorder as judgmental, shaming, or rejecting, particularly in people who have PTSD as a result of combat/military service.[3]:295

Cognitive Behavioral Therapy and Trauma-focused CBT

Cognitive Behvioral Therapy is known to be effective in treating depression and anxiety disorders, which commonly occur in people with Posttraumatic Stress Disorder.(citation needed) Trauma-focused CBT (TFCBT) is Cognitive Behavioral Therapy which has been adapted specifically for treating trauma.

Cognitive Processing Therapy (CPT)

Acceptance and Commitment Therapy (ACT)

Interpersonal Therapy

Prolonged Exposure Therapy

Prolonged Exposure (PE), also known as Exposure Therapy is a trauma-focused treatment which involves multiple sessions of both imaginging and in vivo exposure to the traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. <ref name=Howell2011/>{{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. <ref name=Howell2011/>{{Rp|83}}. Powers (2010) found there was no significant difference between PE and other active treatments, but that treatment led to significant improvements in PTSD symptoms. The average person treated by Prolonged Exposure improved more than over 80% of people with PTSD who were either awaiting treatment, or not in treatment.

Psychodynamic therapy

This talking treatment seeks to reengage normal mechanisms of adaption by addressing what is unconscious, and in tolerable doses, making it conscious.[4]

Eye Movement Desensitization and Reprocessing (EMDR)

This form is treatment is not a typical talking therapy, but can be very effective for PTSD.

Ineffective and less proven treatments

Psychological Debriefing

Treatments which has been investigated but not shown to be particularly effective is Psychological Debriefing for Adults, typically a single session held within a few days of a major trauma and designed to reduce the risk of PTSD or other psychological difficulties.[4]

Couple and Family Therapy

This has only limited number of studies on its effectiveness, mostly involving combat veterans with PTSD. However, all clinicians should consider whether this is appropriate for the situation, and the treatment guidelines recommend it focuses on "improving communication and reducing conflict among family members". One of the key considerations is whether the family situation was dysfunctional prior to the trauma, if it was then further interventions are suggested before the person with PTSD any family therapy. If it is identified as a suitable treatment then couple and family therapy should be used either alongside or following individual therapy, both for adults and children with PTSD.[4]

Emerging treatment innovations which are also being examined to determine their effectiveness, including medication-enhanced psychotherapy, virtual reality exposure therapy, and complementary and alternative medicine-based therapies. [5]

References

  1. ^ Bisson, J., J.; Andrew, M. (2009). Psychological treatment of post-traumatic stress disorder (PTSD)(Review).. The cochrane library, (1)., volume 1.
  2. ^ Powers, Mark B.; Halpern, Jacqueline M., Ferenschak, Michael P., Gillihan, Seth J., Foa, Edna B. (2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, volume 30, issue 6, page 635–641. (doi:10.1016/j.cpr.2010.04.007)
  3. ^ Wilson, John Preston (Ed.) (1994). Countertransference in the treatment of PTSD. New York:Guilford Press.ISBN 0898623693.
  4. ^ a b c Foa, Edna B., Keane, Terence M., Friedman, Matthew J., Cohen, Judith A. (Eds) (2009). Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. Guilford Press.ISBN 1606230018.
  5. ^ Youngner, Cole G.; Gerardi, Maryrose, Rothbaum, Barbara O. (2013). PTSD: Evidence-Based Psychotherapy and Emerging Treatment Approaches. FOCUS, volume 11, issue 3, page 307-314. (doi:doi:10.1176/appi.focus.11.3.307)