PTSD Treatment: A General Overview of Evidence Based Trauma Therapies

Post-traumatic stress disorder (PTSD) can develop after experiencing or witnessing a traumatic event. For example, a natural disaster, a car accident, or military combat. Symptoms of PTSD can include flashbacks, nightmares, and difficulty sleeping, as well as feeling anxious, depressed, or detached. If left untreated, PTSD can interfere with a person's daily life and relationships.

Fortunately, there are effective treatments available for PTSD. In the United States, the most commonly used treatment is therapy with a qualified mental health professional. Talked therapy used to essentially consisted of talking about what was going on and/or diving into the subconscious and your childhood. Sometimes, this helped. Other times, people didn’t notice much of an impact on their trauma symptoms. But, in recent years several specific types of psychotherapy have emerged that make PTSD treatment even more effective. These therapies involve specific protocols that directly target the trauma.

When you see a therapist who uses one of the evidence based PTSD treatments, you stand a much better chance of getting better faster. When you have day to day stress, seeing any therapist you feel supported by is great. But when you start to show symptoms of PTSD, it's important you're working with someone trained in trauma therapy specifically. Someone who can help you find real healing from what happened so you can move forward.

That's what the treatments below help you with.

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Prolonged Exposure

Prolonged exposure therapy (PE) is another evidence-based treatment for PTSD. It helps individuals confront and gradually work through their traumatic memories. Additionally, it looks at related fears that may have developed after or been reinforced by the trauma. The goal of PE is to help individuals habituate, or get used to, their traumatic memories. This increases your brain's confidence that you can handle these things. In turn, it reduces avoidance behaviors and leads to healing.

This is typically done through a combination of in-vivo exposure (i.e., gradually facing and engaging with feared situations or objects in real life) and imaginal exposure (i.e., recounting the traumatic event in detail in therapy). Research has consistently shown that PE is effective in reducing symptoms of PTSD and improving overall functioning.

In fact, PE is often considered the "gold standard" of PTSD treatments. Other treatments are often compared to PE in research studies.

Why Isn’t Everyone Using Prolonged Exposure (PE)?

So, if Prolonged Exposure is the "gold standard," why isn't everyone using it for PTSD treatment? Honestly, at Aspire Counseling we do have multiple therapists trained in PE. Yet, we don't use it very often.

Because PE involves that "in vivo" treatment, many people find it almost re-traumatizing. It's very, very emotionally draining. So, if we can go with one of the other, more gentle treatments we will.

These days, the only time I really use PE is if a client has tried other treatment modalities and hasn't gotten much relief from their PTSD. PE words. I've only ever really had one client go through it and still have significant PTSD symptoms. But it's so draining that I strongly prefer to try other types of treatment first.

Cognitive Behavioral Therapy (CBT)

CBT is a type of therapy that focuses on changing negative thoughts and behaviors. CBT emphasizes the relationship between thoughts, feelings and actions. It can help people with PTSD learn coping skills and ways to manage their symptoms. CBT is essentially the original “evidence based treatment" in psychology. And, specific types of CBT have been developed to treat various things including trauma.

What does cognitive behavioral therapy do? At its core, CBT helps individuals identify and challenge negative thought patterns and behaviors that contribute to their distress. By learning to recognize and modify these patterns, individuals can develop healthier coping strategies and improve their overall well-being.

That said, I'm a little weary when people say they are seeing a therapist for PTSD and doing "CBT." Why? Because a lot of CBT therapists are helping people more generally look at the connection between your thoughts and feelings. And often, this more high level CBT work may not be enough to help you quickly find relief from PTSD.

That said, a lot of therapists may tell you they're using CBT and they're using a more specific version of CBT that has been well researched for PTSD. For example, they may be using Cognitive Processing Therapy or Trauma-Focused Cognitive Behavioral Therapy. As you can see below, both of these are really effective forms of CBT for trauma.

Cognitive Processing Therapy (CPT) 

Cognitive Processing Therapy (CPT) is a cognitive behavioral therapy specifically designed to treat PTSD. CPT involves helping a person identify and challenge negative thoughts and beliefs about their traumatic experience, and teaching them healthy ways to cope with their emotions. The therapy is typically provided in a group or individual setting and involves a series of structured sessions.

During CPT, a person will work with a therapist to identify and challenge negative thoughts, such as "I am weak" or "It was my fault." The therapist will help the person understand how these thoughts may be contributing to their PTSD symptoms and teach them healthy ways to cope with their emotions. CPT may also involve "homework" assignments, such as writing about the traumatic experience or creating a list of positive self-statements.

Several studies have shown that CPT is an effective treatment for PTSD. In one study, CPT was found to be as effective as prolonged exposure therapy, often considered the “gold standard” in treating PTSD, in reducing symptoms of PTSD. However, both clients and clinicians generally seem to view CPT as easier to go through. Other research has found that CPT may be particularly helpful for people with complex PTSD, which is a form of PTSD that occurs after experiencing multiple or prolonged traumatic events. 

CPT is generally a set of 8-16 counseling sessions. That said, there is emerging evidence showing it can be effective in as little as one week. At Aspire Counseling, we have begun offering CPT intensives as a 1-2 week treatment where you come twice a day every day. So far, we’re seeing incredible success. That said, we’ll only offer this as an option when you are following up with regular (at least weekly) counseling afterward.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a therapy that uses eye movements or other types of bilateral stimulation (such as tapping) to help a person process and overcome their traumatic memories. It is believed that the eye movements or other stimulation can help "unlock" the memory and allow a person to process it in a healthy way.

At Aspire Counseling, we have several therapists that are fully trained in EMDR. We really like using this treatment method whether online or in person. Furthermore, we’ve found that it’s a nice compliment to other forms of therapy.

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Psychiatric Medications

Certain medications can also be helpful in treating PTSD. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can help reduce symptoms of depression and anxiety. Other medications, such as prazosin, can help with sleep problems and other physical symptoms related to PTSD. It's important to note that medications should be used in combination with therapy, as they are most effective when used in combination with other treatments.

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Group Therapy

Group therapy can be a helpful treatment for PTSD, as it allows a person to connect with others who have had similar experiences. Group therapy can provide support, understanding, and a sense of community, which can be particularly helpful for people with PTSD. It’s important to note that when group therapy is really effective for PTSD it is often using another form of evidence based treatment. For example, Cognitive Processing Therapy (CPT) can be delivered in a group format.

Alternative Therapies

There are also a number of alternative therapies that have shown promise in treating PTSD. These include acupuncture, yoga, and mindfulness-based therapies. It's important to note that these therapies should generally be used in conjunction with evidence-based treatments and should not be relied upon as the sole treatment for PTSD.

It’s Important to Find a PTSD Treatment That Works for You

It's important to find a treatment that works for you, as everyone is different and may respond differently to different treatments. It may take some trial and error to find the right combination of treatments that work for you. If you or a loved one is struggling with PTSD, it's important to seek help from a mental health professional. With the right treatment, it is possible to manage symptoms of PTSD and improve quality of life.

In conclusion, there are many effective treatment options available for individuals suffering from PTSD. EMDR, CPT and Prolonged Exposure Therapy have all been shown to be effective in reducing symptoms and improving overall well-being. It is important for individuals to work with a trained mental health professional to determine the best course of treatment based on their specific needs and circumstances. While the road to recovery can be challenging, with the right support and treatment, it is possible to manage and overcome PTSD.

PTSD Treatment in Missouri

If you or someone you know is struggling with PTSD and looking for effective, evidence-based treatment options, consider reaching out to the therapists at Aspire Counseling in Missouri. They offer a range of proven counseling techniques, including EMDR, Cognitive Processing Therapy, Prolonged Exposure, and Trauma Focused CBT. If you’re in Mid Missouri or the Kansas City area, we may have in person openings. We’re also able to offer online counseling to anyone in the state of Missouri. So, don't let PTSD control your life any longer. Contact Aspire Counseling today and take the first step toward healing and recovery.

About the Author

Jessica Tappana  is a Licensed Clinical Social Worker and the owner of Aspire Counseling in Columbia, MO. She specializes in treating trauma and anxiety-related issues. Jessica is very passionate about helping those with trauma and PTSD with using evidence based practices and techniques.

If you're ready to start sleeping better, reach out today!