There are a number of treatments for post-traumatic stress (PTSD) that have been shown to be moderately effective. Included among these are prolonged exposure, eye movement desensitization, and cognitive processing therapy (CPT). However, there are elements of these treatments that have made them less than desirable in the clinical community. For instance, they are driven by outcome rather than progress, require a specific number of sessions and are rigid in nature, allowing little room for deviation from their set protocols. The result of these stringent guidelines is a less than optimal client adherence rate and an even less attractive clinician adoption rate.
Tara Galovski of the University of Missouri at St. Louis theorized that perhaps modifying the standard CPT would make it more appealing to clinicians and more beneficial to clients. To test her theory, Galovski enrolled 100 participants with PTSD into the a modified version of CPT (MCPT) or a symptom measured delayed treatment (SMDT), all delivered by novice, rather than expertly trained, clinicians. The unique aspects of the MCPT, which allowed for longer or shorter treatment durations, insertion of stressor sessions to address symptoms as needed, and a protocol designed to focus on progress rather than outcome, proved to be quite effective at decreasing symptoms of PTSD in the participants.
Overall, Galovski found that the MCPT participants had lower levels of depression and PTSD upon completion when compared to the SMDT participants. Additionally, secondary symptoms of well-being, guilt, physical health appraisals, and general functioning also improved. She also discovered that over half of the participants reached positive outcome scores well before the traditional 12th session. Those who didn’t saw improvement with maintenance sessions that continued after the 12th session. These gains were maintained at the three month follow-up assessment. Galovski believes that this modified and more flexible version of CPT meets the needs of the clients and clinicians more comprehensively than some of the more traditional and fixed approaches. For individuals with PTSD who have not had success with existing treatment methods, MCPT may be a viable alternative. “Additionally, for those survivors who may not realize an early or efficient response, continuing the course of therapy may result in continued and substantial gains,” said Galovski.
Galovski, Tara E., Leah M. Blain, Lisa Elwood, Juliette M. Mott, and Timothy Houle. Manualized therapy for PTSD: Flexing the structure of cognitive processing therapy. Journal of Consulting & Clinical Psychology 80.6 (2012): 968-81. Print.
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