Sudden Gains in PTSD Treatment May Predict Positive Outcome

Children and adolescents who suffer from post-traumatic stress benefit from prolonged exposure (PE) treatment if they experience sudden gains early on, according to a new study. Researchers from Boston University and Bar-Ilan University collaborated to determine if children and adolescents who experience sudden gains, defined as improvements that occur in between sessions and account for a decrease in symptoms by at least 25 percent, achieve better outcomes through PE.

The team enlisted 63 children and adolescents, between the ages of 8 and 17, all who sought treatment for PTSD symptoms. The participants were assessed at baseline using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Revised. The team administered 12 to 15 sessions of PE treatment that consisted of three modules, psycho-education, exposure and relapse prevention. The participants were assessed two more times after the conclusion of the treatment, once at approximately three and half months out, and again after 12 months.

The researchers found that of 31 participants, 13 had two episodes of sudden gains and 18 had one episode of sudden gain. The total accounted for 49.2% of the participants experiencing at least one sudden gain, with most of these, 22.7 percent, occurring between the fourth and fifth session of treatment. The researchers used the Child PTSD Symptom Scale (CPSS) to rate the effect of the sudden gains. “The interaction effect was such that participants who experienced sudden gains in post-traumatic symptoms reported greater reductions in CPSS during and after treatment,” said the team. “Sudden gains were also found to predict better outcome at treatment termination and at 3 and 12 months follow-up.” They believe that their findings have significant clinical implications. “It is possible that individuals who do not experience sudden gains by mid-treatment could benefit more from longer, more intensive treatment,” added the researchers. “Conversely, if sudden gains occur during treatment, the treatment course may be shortened.”

Aderka, Idan M., Edna Applebaum-Namdar, Naama Shafran, and Eva Gilboa-Schechtman. “Sudden Gains in Prolonged Exposure for Children and Adolescents With Posttraumatic Stress Disorder.” Journal of Consulting and Clinical Psychology79.4 (2011): 441-46. Print.

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Hanna


    August 15th, 2011 at 5:13 PM

    Any indication of who will be the ones to experience these sudden gains?

  • jillian


    August 15th, 2011 at 11:26 PM

    some people would definitely respond better to treatment than others.and it is encouraging to see that the percentage of such people is fairly high…now we just need to find the reason for the early gain and try to replicate it in others as well.

  • Cason


    August 16th, 2011 at 4:08 AM

    Then I think that what this tells us is that w ehave to work super hard to get these kids to quickly progress in their treatment. There is no time to dawlde here. The sooner they progress then the better their chances are for healing and healing quickly. That has to be a prioroty for anyone dealing with children who are experiencing PTSD.

  • DeXtEr


    August 16th, 2011 at 1:00 PM

    So if I’m not making quick recovery early on,will it not make the doctors pessimistic about me?!I don’t think this is a good way to guauge recovery.

  • larry rhodes

    larry rhodes

    August 17th, 2011 at 11:40 AM

    so what is d reason for some individuals to make quick recovery than others even for similar problems? is their system jus better adjusted to treatment method? if so, then it also means that if a treatment method is nt working great for someone then they should probably try to change the method, sn’t it?

  • TSD


    August 18th, 2011 at 3:50 AM

    is this study implying that if you have a quick recovery then the method of treatment works well for you?really?isn’t that why you have gained in the first place??

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