Cognitive-behavioral therapy for posttraumatic stress disorder: applications to injured trauma survivors

For the outcomes listed above, we reported summary statistics as stated in the included systematic reviews. Internet-delivered CBT may reduce the severity of PTSD symptoms compared with wait-list or usual care, but the evidence is very uncertain, and iCBT may have little to no effect on improving PTSD symptoms compared with non–CBT interventions delivered online, but here as well the evidence is very uncertain. Therapists have to be trained in the method being studied in order to treat clients. Ethical standards typically require training and expertise in a therapy prior to using it to treat others. Therefore, it is impossible to conduct a blind psychotherapy trial in which the therapist is unaware of which method he or she is using.

Some people may need help making an appointment with their health care provider; others may benefit from having someone accompany them to their health care visits. The Substance Abuse and Mental Health Services Administration has a online treatment locator  to help you find mental health services in your area. Not everyone who lives through a dangerous event develops PTSD—many factors play a part. Some of these factors are present before the trauma; others become important during and after a traumatic event. This includes combat veterans and people who have experienced or witnessed a physical or sexual assault, abuse, an accident, a disaster, or other serious events.

Cognitive Behavioral Therapy and PTSD

An additional limitation to this study included a lack of power to detect differences between groups (the authors indicated that 730 participants would have been required to have 80% power to do so). Further, there was potential for bias in the selection of patients from the waiting lists as this did not appear to be done in a random manner. This could compromise the representativeness of the sample and, hence, the generalizability of the results. As well, the experience of the psychologists in CBT and PTSD could influence generalizability. Finally, the participants in the remote region entered the study through self-referral, which may not make them representative of the larger population with PTSD as they were likely motivated to seek treatment. Strengths of this study included the use of standardized measures for which evidence of validity and reliability had been previously demonstrated and a therapeutic integrity check to ensure that the principles of CBT were being adhered to in the interventions.

  • As research continues to transition to the utilization of DSM-5 criteria, it will be essential to update the guidelines informed by the new criteria as this new conceptualization could impact the measurement and efficacy of these treatments.
  • However, there is no clear consensus of what constitutes an effectiveness study (Hans & Hiller, 2013).
  • Britvić et al. (2006) measured symptoms of PTSD intensity, neurotic symptoms, and defence mechanisms in a study of long‐term dynamic orientated group psychotherapy.
  • Additionally, people who are diagnosed with PTSD are also more likely to struggle with addiction—most often in an attempt to self-medicate and dull their symptoms.
  • An exploration of therapists’ experiences using such methods for adult survivors of childhood sexual abuse (Schulz, 2007) reports that clients prefer the intervention because it lessens the possibility of re-traumatization.

We rated the risk of bias for the CADTH systematic review18 as low, using ROBIS (Appendix 2,Table A2). The database search of the clinical literature yielded 1,036 citations published from January 1, 2018, until June 1, 2020. We identified four additional studies from other sources, for a total of 681 after removing duplicates. We assessed risk of bias in each systematic review using the Risk of Bias in Systematic Reviews (ROBIS) tool29 (Appendix 2).

Avoidance symptoms include:

The theoretical underpinnings and major treatment components of CBT for posttraumatic stress disorder (PTSD) are presented, followed by a review of the treatment outcome research to date. As few studies have evaluated CBT for injured trauma survivors, specifically, circumstances and comorbidities of this population, that might impact treatment delivery and outcome are discussed within a cognitive-behavioral framework. The article concludes with recommendations for research and treatment of PTSD among injured trauma survivors that draw from cognitive-behavioral theory and empirically supported principles of change. Because only a single meta-analysis existed examining EFT for PTSD, this evaluation included systematic reviews, randomized controlled trials, and quantitative reviews. Unpublished literature was also included in order to represent the most current research.

post traumatic stress disorder cognitive behavioral therapy

We estimated unit costs from year 1 to year 5 for adults receiving usual care and for those receiving iCBT. Specifically, the treatment cost of $253.53 was applied only to those receiving iCBT in the first year of iCBT treatment. The overall health state cost component combined health state–related costs for those with active PTSD and those with PTSD in remission. The CADTH cost–utility analysis reported the mean values of the probabilistic sensitivity analysis based on 5,000 Monte Carlo simulations as the reference case.18 To be consistent with costs estimated within this approach, our reference case also reflected the probabilistic results. And, as suggested in the current guidelines,65,66 we also reported the deterministic results in a scenario analysis. Interestingly, a subanalysis indicated evidence of greater treatment effect for improvement of PTSD symptoms from the use of trauma-focused iCBT than iCBT without a trauma focus.

Clinical Evidence

We have new and better treatment options today because of what clinical trials uncovered years ago. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. It is important for anyone with PTSD symptoms to work with a mental health professional who has experience treating cognitive behavioral therapy PTSD. The main treatments are psychotherapy, medications, or a combination of psychotherapy and medications. A mental health professional can help people find the best treatment plan for their symptoms and needs. Fortunately, treatments like cognitive behavioral therapy are now available to support this type of trauma healing.

A recent systematic review identified 56 randomized controlled trials of Clinical EFT (Church et al., 2022), many citing and crediting the Chambless and Hope (1996) criteria for their design in the Methods section. Many therapeutic modalities other than Clinical EFT also performed RCTs meeting the criteria. These standards thus influenced the design of hundreds of studies and contributed to an entire generation of high-quality research. In addition to the reference case, the authors conducted many scenario analyses, including analyses on guided iCBT and unguided iCBT, and the use of a 1-year time horizon (Table 5). These scenario analyses suggested that iCBT remained cost-effective compared with usual care.

People should work with their health care providers to find the best medication or combination of medications and the right dose. To find the latest information about medications, talk to a health care provider and visit the FDA website . They can lead to feelings of stress and anger and may interfere with parts of daily life, such as sleeping, eating, or concentrating. Information about resources such as data, tissue, model organisms and imaging resources to support the NIMH research community. The Division of Intramural Research Programs (IRP) is the internal research division of the NIMH.

post traumatic stress disorder cognitive behavioral therapy