What is the Best Therapy Approach for PTSD?

When you have post-traumatic stress disorder (PTSD), it can feel like you'll never get your life back. Fortunately, there are a variety of therapies available that can help you manage your symptoms and reclaim your life. Short-term and long-term psychotherapy and medications can work very well, often in combination. Most therapies for PTSD are included in cognitive behavioral therapy (CBT).

This approach focuses on changing the thought patterns that disrupt your life, either by talking about your trauma or focusing on the source of your fears. Depending on your situation, group or family therapy may be a good option for you instead of individual sessions. Brief eclectic psychotherapy is one type of CBT that combines elements of cognitive-behavioral therapy with a psychodynamic approach. It focuses on changing the emotions of shame and guilt and emphasizes the relationship between patient and therapist.

Cognitive processing therapy (CPT) was developed by Patricia Resick, PhD, ABPP, as a treatment for PTSD. It aims to help people who feel “stuck” in their thoughts about trauma. At first, you'll talk about the traumatic event with your therapist and how your thoughts related to it have affected your life. Writing can also be an effective tool for processing trauma.

In fact, some research has shown that combining writing with other therapies can help shorten treatment time. Recent studies have also shown that meditation and yoga are useful complementary therapies for people with post-traumatic stress disorder. At the beginning of treatment, the therapist will teach you breathing techniques to ease anxiety when you think about what happened. Whether a couple-based approach is as effective as individual trauma-focused therapy for PTSD is not yet known.

Most therapists will use a variety of techniques to treat patients' trauma rather than a single modality. At CPT, your therapist will help you learn to challenge and change the unhelpful beliefs about trauma that keep you “stuck.” It's also important to remember that an important part of therapy is the relationship with the therapist. The CBT category encompasses several types and elements of treatment used by cognitive-behavioral therapists, while cognitive processing therapy, cognitive therapy, and long-term exposure are more specialized treatments that focus on particular aspects of CBT interventions. Internal family systems (IFS) are a type of talk therapy developed by therapist and academic Richard Schwartz, PhD.

There are other psychotherapies that meet the definition of trauma-focused treatment for which there is currently insufficient evidence to recommend their use or against. In an eye movement desensitization and reprocessing (EMDR) session, the therapist will ask you to consider a specific aspect of a traumatic event while focusing on your hand moving back and forth (or, sometimes, on playing rhythmically). A potential advantage of non-trauma-focused treatments is that dropout rates are often lower than those of trauma-focused therapies that are highly recommended. In hypnotherapy, a therapist places you in a trance-like posture, in which you are awake and aware, yet relaxed and able to eliminate distractions.

Stress inoculation training (SIT), Prolonged Exposure Therapy (PCT) and Interpersonal Therapy (IPT) are non-trauma-focused therapies and most of the evidence is derived from clinical trials that have involved direct comparisons with highly recommended trauma-focused therapies.

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