Tell Me More About Post Traumatic Stress Disorder (PTSD).
3. What are the psychological therapies for PTSD?
Psychotherapy can be an effective treatment for PTSD, either in an individual or group setting. Amongst the various psychotherapies, Cognitive Behaviour Therapy (CBT) offers the greatest benefit. CBT involves a detailed assessment of the specific fears, coping mechanisms and beliefs about social situations. A course of CBT typically requires 16 to 20 weekly sessions.
Facing fears through imaginary and direct (in vivo) exposure is an important part of CBT. Equally important is the development of coping strategies, e.g. developing a renewed sense of security through various practical measures.
A more recent treatment, Eye Movement Desensitization and Reprocessing (EMDR) has found limited acceptance.
Routine debriefing after a traumatic event is not necessarily helpful. Recent research suggests that it may focus on the trauma and interfere with moving on.
However, for people clearly suffering from PTSD, psychotherapy is often the best first step in treatment, followed by medication if necessary. Switching medication is recommended whenever treatment response is poor or side-effects are intolerable.
References:
Rothbaum BO, Meadows EA, Resick P and Foy DW Cognitive Behavioral Therapy (Chapter 16) Foa EB, Keane TM and Friedman MJ (2000) Effective Treatments for PTSD. Guilford Press. NY.
Expert Consensus Guidelines, LLC, Foa EB, Davidson JRT and Frances A eds., J Clin Psychiatry 1999;60 (suppl 16).
Rose S, Bisson J and Wesseley S: Psychological debriefing for preventing post traumatic stress disorder. Cochrane Database of Systematic Reviews. Issue 3, 2002. |
