![]() ![]() ![]() (1) Trauma-focused psychotherapies with the strongest evidence There are other psychotherapies that meet the definition of trauma-focused treatment for which there is currently insufficient evidence to recommend for or against their use. Other manualized protocols that have sufficient evidence to recommend use are: specific cognitive behavioral therapies for PTSD (9-17), Brief Eclectic Therapy (BEP 18-20), Narrative Exposure Therapy (NET 21,22),and written narrative exposure (23,24). These treatments have been tested in numerous clinical trials, in patients with complex presentations and comorbidities, in comparison to active control conditions, and with long-term follow-up designs, Furthermore, these treatments have been validated by research teams other than the developers. (4) The trauma-focused psychotherapies with the strongest evidence from clinical trials are PE (5), CPT(6), and EMDR (7,8). The CPG defines trauma-focused psychotherapy as therapy that uses cognitive, emotional, or behavioral techniques to facilitate processing a traumatic event and in which the trauma focus is a central component of the therapeutic process. Trauma-Focused Psychotherapies Conclusion References Trauma-Focused Psychotherapies Overview Results of recent meta-analyses suggest that either one can reduce PTSD symptoms. There are no data to guide whether medication or non-trauma-focused psychotherapy is more effective in cases where trauma-focused psychotherapy is unavailable or not desired. In such cases, the CPG recommends treatment using medication (specifically, sertraline, paroxetine, fluoxetine, or venlafaxine see Clinician's Guide to Medications for PTSD) or certain individual, manualized psychotherapies that are not trauma-focused (specifically, Stress Inoculation Training, present centered therapy, and Interpersonal Psychotherapy see below). Individual trauma-focused psychotherapies may not be available in all settings and not all patients choose to engage in these treatments. In addition, the risks for negative side effects or negative reactions are generally greater with medication than with psychotherapy. (2,3) The results showed that trauma-focused psychotherapies lead to greater improvement in PTSD symptoms than medications, and that these improvements last longer. ![]() (1) Although there have been few direct head-to-head comparisons of trauma-focused psychotherapy and a first-line medication for treating PTSD, two recent meta-analyses compared the treatment effects of psychotherapies and pharmacotherapies. The CPG (2017) recommends treating PTSD using individual trauma-focused psychotherapy (e.g., PE, CPT, EMDR) over medications based on the current state of the PTSD treatment research. Individual Trauma-Focused Psychotherapy Recommended Over Other Treatments for PTSD VA Software Documentation Library (VDL).Clinical Trainees (Academic Affiliations).War Related Illness & Injury Study Center. ![]()
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