Study Finds PTSD Is Not Being Treated Correctly

Close up of soldier's face in shadowsPosttraumatic stress (PTSD) can have life-altering symptoms, including intrusive flashbacks, chronic fear and depression, difficulty with relationships, nightmares, and feeling numb. With about 5 million people experiencing PTSD in any given year and 7% to 8% of the population experiencing it in their lifetimes, there’s a strong incentive for clinicians to provide excellent treatment. Unfortunately, a recent study found that many treatment providers are not offering the most effective treatment options.

Effective PTSD Treatments

Posttraumatic stress can be challenging to treat, and some people have to try several therapists before they find one who meets their needs. A good rapport with a therapist, feeling safe, and a home environment that fosters recovery are all helpful. However, there are a few clinically validated treatments for PTSD.

Prolonged exposure therapy helps a person with PTSD to gradually become comfortable with situations, people, or thoughts he or she had previously avoided. A client might imagine a frightening scenario and then build up to actually going to a frightening location. Over time, this can reduce the avoidance and panic aspects of PTSD. Cognitive behavioral therapy, which helps clients to reprocess trauma and become more mindful of the ways in which damaging thoughts affect emotions and behavior, can also be highly effective.

Study Results

Led by Edna Foa, a trauma researcher who pioneered the use of prolonged exposure therapy, the study looked at various treatments used to treat veterans experiencing PTSD. The majority of treatment protocols did not use prolonged exposure therapy or cognitive behavioral therapy. Instead, mental health professionals were more likely to use psychodynamic techniques such as discussing early childhood events, parental relationships, or early memories. Coping skills therapy and group therapy were also popular options for treating PTSD.

The authors of the study note that the strategies therapists and other mental health professionals are using are not necessarily bad or ineffective. Instead, these approaches are not evidence-based, while exposure therapy and cognitive behavioral therapy have been proven effective among people experiencing PTSD.

What’s Going Wrong?

In a world filled with new research on PTSD, it may be that some treatment professionals aren’t aware of what practices are supported with scientific evidence. The study’s authors noted that many therapists believe that treatment needs to be individualized, and this process of individualization can cause them to move away from exposure therapy and cognitive behavioral therapy, which tend to be fairly formulaic. Tradition can also play a role. Many people with PTSD want support from others with the condition, so group therapy is popular, particularly among veterans. The fact group therapy has been so frequently used might make it hard to move toward scientifically validated treatments.

It’s also possible that therapists aren’t using ineffective treatments at all. The most popular PTSD treatments have not been demonstrated to be wrong. Rather, they’re not supported by scientific evidence. As researchers do more studies on PTSD, they may find that a wide variety of treatments can be effective.

References:

  1. How common is PTSD? (n.d.). National Center for PTSD. Retrieved from http://www.ptsd.va.gov/public/pages/how-common-is-ptsd.asp
  2. Karlin, B. E., & Agarwal, M. (2013). Achieving the promise of evidence-based psychotherapies for posttraumatic stress disorder and other mental health conditions for veterans. Psychological Science in the Public Interest14(2), 62-64. doi: 10.1177/1529100613484706
  3. Most effective PTSD therapies are not being widely used, researchers find. (2013, April 11). Association for Psychological Science RSS. Retrieved from http://www.psychologicalscience.org/index.php/news/releases/most-effective-ptsd-therapies-are-not-being-widely-used-researchers-find.html

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  • Donna

    Donna

    June 3rd, 2013 at 3:07 PM

    Much of this all boils down to the fact that what works for one person is not necessarily going to work for another.
    Therapy and treatment have never been one size fits all, and it never will be.
    I think that you have to work with the therapist and treatment team to decide what is the best approach and go with that.
    It could be that you have to try several different things before you land on the correct approach.
    It is out there for you, but it might take a little trial and error.

  • jenn

    jenn

    June 4th, 2013 at 3:48 AM

    Do you think that there could be a problem with providers trying to give care even in areas where they are not the most familiar other than just referring out to someone who may be better qualified to treat the patient?

  • george.m

    george.m

    June 4th, 2013 at 8:58 AM

    as long as they do not try out these evidence based techniques they are not going to find out how much better or worse it is.they will continue to use the old techniques and no change will happen.they really should be given suggestions on using these because it is for the benefit of those affected after all.

  • CHRISTA

    CHRISTA

    June 5th, 2013 at 12:12 PM

    Just because there are treatments with scientific backing does not mean the currently employed treatments are wrong.They may be better but would also need more testing and experimentation.The current treatments have been through years and decades of observation and I’m sure have been tweaked.A combination of old and new would be great in my view.

  • David Lillie

    David Lillie

    June 21st, 2013 at 8:54 AM

    I’m dubious about the long term effectiveness of CBT on most trauma,but treatments like somatic experiencing (SE), sensorimotor psychotherapy and EMDR are effective in the long term. There are several studies of EMDR available, and studies are in progress for SE. The main problem with many therapies is that they don’t release the trauma that’s stored in the body on in implicit memories, which must be resolved for long term benefits.

  • Chris G.

    Chris G.

    December 18th, 2014 at 7:56 PM

    I’m also dubious about the use of CBT for trauma, since essentially it instructs victims to suppress symptoms as “negative thoughts” and use “positive replacement” thoughts as a band-aid, claiming that “feelings come from thoughts.”
    But this is entirely misleading in cases of trauma– but the worst crime is the suppression of client-symptoms as “secondary gains,” essentially denying the failure of CBT by blaming the client as refusing to cooperate out of self-pity, “secondary gains” of getting something out of the symptoms, etc.
    This “victim-blaming” is nothing new in psychology; in fact it was Freud’s motivation for finding reasons behind the typical claim that ill workers were “gold-bricking” since they had no physical ailments.

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