Is exposure therapy the only effective way of treating Post-Traumatic Stress Disorder (PTSD)?
There are two claims here:
- Exposure therapy is an effective way of treating PTSD.
- Exposure therapy is the only effective way of treating PTSD.
Is it an effective way?
Cognitive behavioral therapy (CBT) is a short-term psychotherapy originally designed to treat depression, but is now used for a number of mental illnesses.
CBT has been proven to be an effective treatment for PTSD and is currently the standard of care for PTSD by the United States Department of Defense.
Exposure therapy is one modern form of CBT.
Numerous studies have demonstrated its effectiveness in treating PTSD; apa.org reported:
In the 1980's, Dr. Terence M. Keane and his colleagues found that exposure therapy was effective in treating the PTSD symptoms of Vietnam War veterans. Exposure therapy, previously known as imaginal flooding therapy, involves carefully exposing the patient to prolonged and repeated imagined images of the trauma until the images no longer cause severe anxiety.
Research by Dr. Edna B. Foa and her colleagues showed that exposure therapy was effective in reducing PTSD symptoms of rape victims, including persistent fear. The improvements were seen immediately after exposure therapy, and were shown to be sustained during a three-month follow-up.
Citation:
Keane, T. M. & Kaloupek, D. G. (1982). Imaginal flooding in the treatment of a posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 50, 138-140.
Keane, T. M., Fairbank, J. A., Caddell, J. M., & Zimering, R. T. (1989). Implosive (flooding) therapy reduced symptoms of PTSD in Vietnam combat veterans. Behavior Therapy, 20, 245-260.
Claim: valid.
Is it the only effective way?
Wikipedia's article claims that there are several types of psychotherapy with strongly demonstrated efficacy,
The psychotherapy programs with the strongest demonstrated efficacy include cognitive behavioral programs, variants of exposure therapy, stress inoculation training (SIT), variants of cognitive therapy (CT), eye movement desensitization and reprocessing (EMDR),[79] mindfulness-based meditation[80] and many combinations of these procedures.[81]
It goes on to say that,
EMDR and trauma-focused cognitive behavioral therapy (TFCBT) were recommended as first-line treatments for trauma victims in a 2007 review; however, "the evidence base [for EMDR] was not as strong as that for TFCBT ... Furthermore, there was limited evidence that TFCBT and EMDR were superior to supportive/non-directive treatments, hence it is highly unlikely that their effectiveness is due to non-specific factors such as attention."[82] A meta-analytic comparison of EMDR and cognitive behavioral therapy found both protocols indistinguishable in terms of effectiveness in treating PTSD; however, "the contribution of the eye movement component in EMDR to treatment outcome" is unclear.[83]
If we take for example EMDR, meta-study concluded that there is evidence that it is effective:
Eye Movement Desensitisation and Reprocessing (EMDR) is now considered evidence based practice in the treatment of trauma symptoms. Yet in a previous meta-analysis, no significant effect was found for the eye movement component. However methodological issues with this study may have resulted in a type II error. The aim of this meta-analysis was to examine current published studies to test whether eye movements significantly affect the processing of distressing memories.
Other than psychological treatments, medications including fluoxetine and paroxetine might improve symptoms in a small amount.
Claim: not fully valid. While exposure therapy (form of CBT) is an effective therapy; it is not the only one there.
