Therapies for specific symptoms and populations

Psychosocial treatments for specific populations include treatments for children, people with co-occurring substance use, for veterans, and other groups.

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Therapies for adults with a history of childhood abuse

How does PTSD in adults with a history of childhood abuse differ from PTSD in other adults? Adult survivors of childhood abuse tend to have more symptom complexity than other adults with PTSD. This complexity includes emotion dysregulation, interpersonal problems, impulsive and/or self-destructive behaviour, high levels of dissociation, substance-related problems, and unexplained physical symptoms. For PTSD in general, the best evidence currently exists for trauma-focussed treatments such as cognitive behaviour therapy (CBT) and eye movement desensitisation and reprocessing (EMDR). These interventions involve processing the memory of the trauma and its meaning based on theoretical models that emphasise the role of…

Therapies for children and adolescents

How is PTSD relevant for children and adolescents? Traumatic events are highly prevalent in childhood and adolescence. PTSD is often chronic and has immense personal and social costs, and the prognosis for recovery without adequate treatment is poor. Therefore, early and effective treatment is important. What is the evidence for psychological therapies for PTSD in children and adolescents? Moderate quality evidence found a large improvement in PTSD symptoms with psychological treatments by the end of treatment, and a medium-sized improvement by six months post-treatment when compared to untreated or waitlist controls. Compared to treatment as usual or active controls, there…

Therapies for complex PTSD

What is complex PTSD? Complex PTSD can arise from chronic violence or abuse. It is conceptualised as the core symptoms of PTSD (re-experiencing the trauma, avoidance of traumatic reminders, and exaggerated startle and hypervigilance) plus disturbances in self organisation, affect dysregulation, negative self-concept, and relationships. People with complex PTSD may also show high levels of depression, psychological distress, dissociation, and substance misuse. What is the evidence for psychological therapies for complex PTSD? Moderate to low quality evidence found large improvements in PTSD symptoms with psychological treatments pre- to post-treatment in adult women with a history of childhood abuse. The effect…

Therapies for dual diagnosis

What is dual diagnosis? Dual diagnosis describes a condition when a person with both a mental health diagnosis such as PTSD and a substance use disorder. This comorbidity is associated with poorer treatment outcomes than for either condition alone. Several psychological therapies are successful at treating each disorder individually, however when occurring together, they may be harder to treat. What is the evidence for psychological therapies for dual diagnosis? Moderate to low quality evidence found a small improvement in PTSD symptoms in people with a dual diagnosis following individual psychological treatments that have a trauma-focus when compared to treatment as…

Therapies for people living in low- and middle-income countries

How is PTSD relevant to people living in low- and middle-income countries? Many people living in low- or middle-income countries are exposed to adversities, including conflict and war. PTSD is prevalent in such communities. In developing countries, most people with PTSD do not receive adequate care due to insufficient mental health services and challenges in implementing evidence-based interventions that are adapted to their specific needs. Non-specialist health workers and other professionals such as teachers, may have an important role to play in delivering mental health care in these settings. What is the evidence on effectiveness of therapies for PTSD in…

Therapies for prevention of PTSD

Can PTSD be prevented? Early intervention models suggest psychological interventions given to any individual exposed to a traumatic event may prevent the onset of trauma-related symptoms and a diagnosis of PTSD. Cognitive behavioural therapy (CBT) is one of the most common psychological treatments that are effective for the treatment of PTSD. CBT challenges distorted, negative thinking patterns associated with the trauma to help people develop more adaptive cognitions and behaviours, and to rethink assumptions and reactions to the event. Exposure therapies are also frequently recommended for treatment. These aim to desensitise people to trauma-related memories and to help people overcome…

Therapies for refugees and asylum seekers

How is PTSD relevant to refugees and asylum seekers? Over the past two decades, the number of forcibly displaced migrants has grown due to ongoing conflicts in countries around the world. Compared to the general population, refugees experience considerably higher levels of psychological distress due to major losses and exposure to events such as torture and war. Post-displacement stressors are also apparent, including those associated with resettlement, language barriers, and perceived stigma and discrimination. Any of these trauma exposures can contribute to higher rates of mental health conditions, including PTSD, depression, and anxiety. What is the evidence on therapies for…

Therapies for soldiers and veterans

How is PTSD relevant to soldiers and veterans? Soldiers and veterans have exposure to life threatening stressors, including combat, injury, and witnessing suffering and death. These traumatic combat experiences are often less straightforward than single traumatic events, which may decrease PTSD treatment effectiveness. Interventions that may be effective for PTSD in soldiers and veterans include eye movement desensitisation and reprocessing, exposure therapy, cognitive therapy, cognitive restructuring therapy, cognitive processing therapy, trauma-focused cognitive behavioural therapy, and stress management. What is the evidence on therapies for PTSD symptoms in soldiers and veterans? Moderate to low quality evidence found large improvements in PTSD…

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