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Therapies for prevention of PTSD

What is psychotherapy for the prevention of PTSD?

Early intervention models suggest psychological interventions given to an individual exposed to a traumatic event may prevent the onset of trauma-related symptoms.

Cognitive therapies are based on the theory that an individual’s perception of a situation influences his or her emotional response to it. They aim to help people identify distorted thinking and to modify existing beliefs. Cognitive processing therapy is a type of cognitive therapy that involves psychoeducation, written accounts about the traumatic event, and cognitive restructuring to address beliefs about the event’s meaning and its implications.

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. It aims to help people develop more adaptive cognitions and behaviours, and to rethink assumptions and reactions to the event.

Exposure therapies to desensitise people to trauma-related memories by exposing them to specific and non-specific cues related to the trauma.

Eye movement desensitisation and reprocessing (EMDR) involves the patient focussing on a disturbing image, memory, emotion, or cognition associated with the trauma while the therapist initiates rapid voluntary eye movements. This is based on the observation that the intensity of traumatic memories can be reduced through eye movements, although the underlying mechanisms remain unclear.

Other therapies include narrative therapy, which can be used to help people reconstruct a consistent narrative about the trauma. Psychoeducation may help normalise stress reactions. Psychodynamic therapy can help people process the trauma emotionally and gain a better understanding of their responses to it. Supportive therapy involves counsellors giving support, listening, and helping people talk over their problems. Family therapy focusses on improving family communication and functioning.

What is the evidence on effectiveness of psychotherapy for prevention of PTSD?

Moderate quality evidence found a medium-sized reduction in rates of PTSD diagnosis, and more improvement in PTSD symptoms for up to one month following psychological therapy (mostly CBT) in children and adolescents exposed to trauma. However, these effects were not significant over the longer term. Direct comparisons between interventions showed no differences in rates of PTSD diagnosis in children receiving CBT, EMDR, or supportive therapy. However, CBT was better than EMDR, play therapy, and supportive therapy for PTSD symptom improvement.

There was a small reduction in PTSD diagnoses in adults exposed to trauma by 3-6 months following multiple-session, early psychological interventions. However, there were no differences immediately post-treatment or at 7-12 months after treatment. There were also no differences in PTSD symptom severity, depression, anxiety, or quality of life. Authors report a high risk of bias in the included trials.

August 2021

Image: ©Antonio Diaz – stock.adobe.com

Last updated at: 2:56 am, 13th October 2021
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Tags:  Early detection Early intervention Prevention Prodrome

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