PTSD Treatment

Psychological Injury Consultants practice only psychological treatments that have demonstrated scientific merit for reducing PTSD symptoms. Our consultants are trained in effective PTSD treatments and adhere to practice guidelines put forth by the International Society of Traumatic Stress Studies (ISTSS). The ISTSS treatment guidelines for PTSD are based on research results from well-controlled randomized trials and multiple, systematic meta-analytic reviews. Accordingly, our consultants are well-versed in providing the following best-practice treatments for reducing PTSD and related problems (e.g., depression, other anxiety disorders).

 

Cognitive-Behavioural Therapies (CBTs): The most common and well-researched CBTs for PTSD include prolonged exposure therapy (PE), cognitive therapy, and stress-inoculation training (SIT). Long-considered as the gold standard treatment for posttraumatic stress, in PE clients are asked to describe their traumatic experiences in detail, on a repetitive basis, in order to reduce the arousal and distress associated with their memories. Although this can be a distressing procedure at first, high levels of distress tend to be a temporary part of this treatment. PE is typically conducted in two ways: imaginal exposure where highly distressful memories are repeatedly reexperienced in memory; and in-vivo exposure where patients confront gradually feared situations. In cognitive therapy, patients are taught to identify their trauma-related negative beliefs (e.g., guilt or mistrust of others) and change these beliefs to reduce distress. In SIT, patients are taught skills for managing and reducing anxiety, including breathing retraining, muscle relaxation, and adaptive self-talk. CBTs often include a combination of methods and education about PTSD. Other CBT methods may be used in addition to treat related problems (e.g., anger, depression, chronic pain).

 

Eye Movement Desensitization and Reprocessing (EMDR): EMDR involves having patients bring to mind images of the trauma and/or trauma-related negative beliefs while engaging in back-and-forth eye movements (or other ways of focusing attention back and forth using sounds or taps). Similar to exposure therapy, EMDR is based on the notion that repetitive processing of traumatic experiences gradually reduces patient’s fear and avoidance of traumatic memories. Although controversy surrounding the effectiveness of EMDR exists, evidence supporting the use of EMDR has advanced in recent years, and the technique is now included as one of the most effective PTSD treatments.

 

Combination Treatments: Experts in PTSD recognize that often no single treatment may be completely effective. Other therapies that combine elements of one or more effective treatments may be necessary to help individuals reduce their symptoms and return to normal lives. For example, cognitive processing therapy (CPT) combines elements of exposure to the traumatic memory with cognitive techniques focused on themes such as safety, trust, control, and self-esteem. Dialectical behaviour therapy (DBT) is another combination treatment that can be effective for those with PTSD to help with emotional control, problems in interpersonal relationships, and repairing a sense of identity. Acceptance and commitment therapy (ACT) can help those with PTSD overcome debilitating avoidance by increasing commitment and behaviour towards living in ways that are consistent with personal beliefs and values.