TREATMENT for Posttraumatic Stress Disorder (PTSD)
Many people who encounter a traumatic experience will not develop PTSD or another psychological condition, and in others, where initial symptoms of stress do appear, they may resolve without needing to seek any assistance.
However some will develop PTSD or some other trauma-related condition for which psychological therapy will be required. In some cases medications are prescribed to assist people recovering from a traumatic experience. Medication is often prescribed in addition to psychological therapy, rather than being a substitute for therapy. You should consult a general practitioner or psychiatrist for further information on whether medications may be of assistance in managing your PTSD.
There are a range of psychological treatment approaches for PTSD, many of the most widely employed approaches come under the umbrella of the title Cognitive Behaviour Therapy (CBT). CBT therapies involve practical techniques designed to alter thoughts and behaviour which are believed to in turn alter the emotions experienced in PTSD.
One component that is common to most PTSD treatments is some form of a strategy which involves “dealing with” the memory of a traumatic event. Some approaches, such as exposure therapy, do this very directly, through a series of sessions designed to “desensitise” a person to their traumatic memories. Other therapies, such as Cognitive Therapy, attempt to alter thoughts about the traumatic memory using a range of techniques such as thought challenging.
Therapies which are directed towards those with chronic and complex PTSD, such as those who also suffer from Borderline Personality Disorder (BPD), tend to leave trauma-focused strategies until late in treatment, and work on teaching more present-focused practical coping techniques in the early stages of therapy.
Below are just some of the main approaches to treating Posttraumatic Stress Disorder. While some therapists use just one of the approaches below, in practice many therapists use a combination of therapy approaches to address the unique PTSD symptoms of each client.
Also you as a client, having discussed the various approaches to PTSD treatment with your therapist, may prefer a particular approach or approaches to PTSD therapy. In this way your preferences may be another factor that guides treatment, and guides the selection of a therapist in some cases.
Cognitive therapy is a form of psychological therapy designed to teach people skills to identify and change unhelpful thinking patterns. Techniques such as completing self-monitoring thought diaries are used to assist people in recognising thoughts that lead to negative emotions such as fear, guilt, shame, and anger. Negative thoughts are challenged using a range of strategies such as presenting contrary evidence. Cognitive therapy for PTSD can involve dealing with current thoughts (eg. thoughts like “It could happen to me again any time”) and / or dealing with thoughts to do with traumatic memories (eg. “I should have acted differently – then things would have turned out OK”).
Recent research suggests that Cognitive Therapy that focuses on traumatic images may be a particularly powerful way of overcoming PTSD.
Prolonged Exposure (PE): Imaginal and / or In Vivo
Exposure techniques involve the PTSD sufferer confronting memories of the traumatic event in order to reduce the extent of negative emotion associated with the traumatic memory. There is now a lot of research evidence to suggest that prolonged exposure is an effective treatment for many people with PTSD. The memory is confronted in several sessions of visualisation to “desensitise” a person to the trauma memory. Prolonged exposure can sometimes produce improvements quite quickly.
Because exposure therapy involves confrontation of trauma memories or situations that can produce strong emotions, it is recommended you seek treatment from a mental health professional with training in the treatment of PTSD and other trauma conditions. “Graded exposure”, exposure in steps starting with facing less upsetting thoughts or situations, and other variations of PE, are sometimes used to reduce the level of emotion experienced during PTSD treatment.
Imaginal exposure involves dealing with the memory of a traumatic event in the imagination. It is often particularly effective at reducing intrusion symptoms such as: nightmares, flashbacks and strong sensory recollections of the traumatic event.
In Vivo Exposure
In Vivo, or “real life” exposure, involves assisting a PTSD sufferer, often in very small steps, to confront reminders of the traumatic event. In Vivo exposure can often be particularly effective in reducing the extent to which people with PTSD avoid situations, a symptom which can have a significant impact on work, study, relationships and other key aspects of daily life.
Anxiety Management Training
Anxiety Management training is a form of CBT which is designed to address the general anxiety symptoms of PTSD. It may involve strategies such as relaxation training, basic education about behavioural strategies to assist in minimising anxiety, “sleep hygiene” measures to improve sleep, etc.
While anxiety management training does not necessarily tackle the underlying cause of PTSD, it can assist in reducing the severity of symptoms and therefore improving a PTSD-sufferers ability to function in everyday activities.
Schema therapy is a form of Cognitive Therapy developed by psychologist Jeffrey Young, that emphasises recognising and shifting the core beliefs, or schemata, underlying negative thinking. It is sometimes used in the treatment of complex PTSD and Borderline Personality Disorder (BPD).
Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a form of psychological therapy for PTSD developed by psychologist Francine Shapiro, which involves allowing a person to process thoughts and emotions connected with traumatic memories while making eye movements facilitated by the therapist.
While there is some debate about whether the eye movements are a necessary component to the treatment, several studies have shown the overall EMDR package to be effective in treating PTSD.
Traditional Trauma Counselling & Trauma Debriefing
While for some time it was believed by many, that “debriefing” for everyone who had experienced a traumatic event would reduce the number of people who developed PTSD. There is now some significant doubt over whether such debriefing is always helpful, and whether, in some cases, it may be harmful.
Many people will benefit more from practical support than psychological therapy in the initial hours following a traumatic event. However some will require psychological assistance early on. If in any doubt, consult a GP or mental health professional.
Mindfulness Therapy & Acceptance and Commitment Therapy (ACT)
Over the past 10 years a number of therapies have emerged which focus on a group of techniques / approaches known as mindfulness. These techniques have been borrowed from Eastern Religions and incorporated into psychological therapy. While there have been some research trials showing the effectiveness of mindfulness based therapies for certain problems (not necessarily PTSD), research on these therapies is in its early stages.
Acceptance & Commitment Therapy (ACT) is a new form of psychological therapy based on a stream of Behavioural research known as Relational Frame Theory. Mindfulness techniques are an important feature of ACT therapy treatments. Again research on this therapy approach is in its early stages.
FOR MORE UP TO DATE AND DETAILED INFORMATION ON WHAT RESEARCH SUGGESTS ABOUT THE MOST EFFECTIVE AND EMPIRICALLY VERIFIED TREATMENTS FOR PTSD WE SUGGEST YOU GO TO: (PosttraumaticStressDisorder.com.au is not associated with this suggested link and takes no responsibility for content):
Australian Centre for Posttraumatic Mental Health
If you have difficulty understanding the information on this site you may wish to discuss it further with a psychologist of psychiatrist with expertise in PTSD treatment.
IMPORTANT NOTE: This page and this site describe general information only about PTSD treatment which may not apply to your situation. This page does not provide enough information to be able to make any decisions about diagnosis or treatment of PTSD. Research is constantly advancing and so you should seek the advice of experts on what treatments are ideal for your condition. Information should NOT be used for diagnosis or treatment purposes. You should consult a GP, Clinical Psychologist, or other mental health professional for advice on your symptoms and the most appropriate treatment(s).
For details how to find a therapist / psychologist near you with expertise in PTSD treatment
click here .
For 24 hour telephone counselling in Australia call Lifeline on 13 11 14. For urgent assistance call your local mental health service, or attend your GP or your nearest hospital.