In addition to medicines, other treatments are available to help you manage PTSD. These include the following:
Cognitive-behavioral therapy (CBT) can help you examine your feelings and thought patterns. It can help you learn to interpret them in a more realistic way and apply coping techniques. CBT can teach you coping skills such as breathing exercises, to reduce anxiety, negative thoughts, and anger. It may also help you handle future trauma, reduce your urge to use alcohol or drugs to cope, and help you relate better with people. Multiple sessions of CBT may be most helpful in treating PTSD.
One form of CBT commonly used with trauma survivors is exposure therapy. This therapy relies on repeatedly discussing the trauma with a therapist in a safe, therapeutic setting. The goal is to decrease negative feelings from the trauma, help you develop relaxation skills during stressful times, and eventually decrease the influence of the memory. Some methods of exposure include:
PET may be more effective than EMDR and relaxation therapy in reducing occurrences of re-experiencing symptoms and reducing avoidance.
Another type of CBT is called cognitive processing therapy (CPT). This therapy focuses on better understanding how the traumatic event affected your thought process. Our need to make sense of what happened can cause us to get stuck in thought patterns that prevent us from moving on. CPT works to identify these patterns and develop skills to question those thoughts when they arise. These skills can help manage feelings about the trauma and day to day challenges. CPT will also help you examine how the trauma may have changed your beliefs such as self esteem, personal safety, control, and relationships. Examining the differences in your beliefs before and after the trauma can help you establish a new middle ground. The therapy focuses on the changes to your thought pattern since the trauma and how this change affects how you act and feel.
CPT may be an effective counseling therapy for veterans with PTSD.
Eye movement desensitization and reprocessing (EMDR) is a new therapy for trauma survivors. It includes exposure therapy and cognitive-behavioral therapy combined with eye movements. This results in a shifting of attention. It is believed that this technique may help you access and process traumatic material.
Group therapy allows you to share your traumatic experience in a safe, strong, and supportive environment with other trauma survivors. A group setting can help you gain understanding and trust as you face your anger, grief, anxiety, and guilt about the trauma. Through group therapy, you can learn to cope with symptoms, memories, and other painful parts of your life.
Brief psychodynamic psychotherapy helps you deal with emotional conflicts caused by the traumatic experience, especially as they relate to childhood events. This type of therapy will help you build a greater sense of self-esteem and develop better ways of thinking, coping, and dealing with intense emotions. Your therapist can also help you identify current situations that trigger traumatic memories and worsen PTSD symptoms.
During stress inoculation training, you will be trained in relaxation techniques, positive reframing of negative thoughts, and assertive communication.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.
Cloitre M, Stovall-McClough KC, Nooner, K. et al. Treatment for PTSD related to childhood abuse: a randomized controlled trial. Am J Psychiatry. 2010;167(8):915-924.
Foa EB, Dancu CV, Hembree EA, et al. A comparison of exposure therapy, stress inoculation training, and their combination for reducing post-traumatic stress disorder in female assault victims. J Consult Clin Psychol. 1999;67(2):194-200.
McLay RN, Graap K, Spira J, et al. Development and testing of virtual reality exposure therapy for post-traumatic stress disorder in active duty service members who served in Iraq and Afghanistan. Mil Med. 2012;177(6):635-642.
Posttraumatic stress disorder (PTSD). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114915/Posttraumatic-s...ss-disorder-PTSD. Updated June 26, 2017. Accessed February 1, 2018.
Posttraumatic stress disorder (PTSD). Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/posttraumatic-stress-disorder-ptsd. Updated May 2014. Accessed February 1, 2018.
PTSD basics. National Center for PTSD—US Department of Veterans Affairs. Available at: https://www.ptsd.va.gov/public/PTSD-overview/basics/index.asp. Updated April 17, 2017. Accessed February 1, 2018.
Roberts NP, Kitchiner NJ, Kenardy J, Bisson JI. Systematic review and meta-analysis of multiple-session early interventions following traumatic events. Am J Psychiatry. 2009;166(3):293-301.
Taylor S, Thordarson DS, Maxfield L, et al. Comparative efficacy, speed, and adverse effects of three PTSD treatments: exposure therapy, EMDR, and relaxation training. J Consult Clin Psychol. 2003;71(2):330-338.
DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114915/Posttraumatic-s...ss-disorder-PTSD: Schnurr PP, Friedman MJ, Engel CC, et al. Cognitive behavioral therapy for post-traumatic stress disorder in women: a randomized controlled trial. JAMA. 2007;297(8):820-830.
Last reviewed December 2017 by EBSCO Medical Review Board Adrian Preda, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.