In Israel, PTSD has been a significant concern, even before October 7. With a PTSD prevalence rate of 9%, the incidents of this condition are two to three times higher than the rates observed in the United States and other OECD countries. The good news is that there are viable treatments for PTSD, and they are in use with measurable success.
What you need to know about PTSD
PTSD is a mental health condition triggered by experiencing or witnessing a traumatic event, characterized by symptoms such as flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event, which can significantly impair daily functioning and quality of life. PTSD symptoms occur following exposure to a traumatic stressor and include distressing reminders of the event, hypervigilance, avoidance of reminders, and persistent negative changes in thoughts and mood. For most individuals, PTSD symptoms wane within a year of trauma exposure.
Various factors contribute to the resilience or susceptibility of an individual to PTSD following trauma. These include biological factors, personal history, the nature and severity of the traumatic event, and the support system available to the individual after the event.
Most people who are exposed to traumatic events will not develop PTSD and for most individuals, PTSD symptoms wane within a year of trauma exposure. But after the October 7 attacks, the mental health profession is bracing for a substantial surge in such diagnoses and many mental health professionals are training in evidence-based tools that will help them treat trauma-exposed individuals.
Current treatments for PTSD
The goal of any treatment for PTSD is to decrease the patient’s negative symptoms, teach patients how to better cope, and give those suffering their self-esteem back. It is beneficial for those who suffer from PTSD to be familiar with the following treatment options and even more crucial for healthcare professionals to gain a greater understanding of the effective tools available to support their patients' healing.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a targeted approach for individuals grappling with severe emotional and psychological distress from traumatic experiences. It employs a structured, brief (usually 12-16 sessions) method that merges cognitive and behavioral techniques with trauma-sensitive principles tailored to the individual's specific needs. Through this combination, TF-CBT aids in processing trauma, teaches strategies for managing troubling thoughts and feelings, and enhances social interactions that trauma may have affected. The goal is to lessen the trauma's effects, promoting recovery and resilience. TF-CBT is particularly effective for children and a highly recommended therapy for treating trauma in young people. Numerous clinical trials and studies confirm TF-CBT's success in reducing PTSD symptoms and associated emotional and behavioral challenges. The involvement of parents or caregivers in the therapy process notably boosts its effectiveness and speeds up healing. Success depends heavily on therapists' training and adherence to the therapy model. Although TF-CBT is generally well-received, customization to fit the unique needs and developmental stages of each individual is crucial. Current research focuses on refining TF-CBT to cater to various groups and environments, aiming to keep it culturally sensitive and broadly accessible.
Cognitive Processing Therapy (CPT) is a specialized form of cognitive-behavioral therapy that is well-researched and effective in treating Post-Traumatic Stress Disorder (PTSD). CPT typically includes 12 to 16 sessions focused on identifying and challenging unhelpful beliefs tied to the trauma and altering these beliefs to lessen PTSD symptoms. CPT focuses on helping individuals confront and reassess their beliefs about the trauma and its aftermath, which in turn helps alleviate PTSD symptoms. It encourages patients to understand their traumatic events better and develop healthier, more realistic views of them. Patients are guided to construct a coherent narrative of their traumatic experience and to comprehend how their thoughts about the trauma have influenced their emotions and behaviors. Multiple studies back the efficacy of this therapy, showing it can significantly reduce PTSD symptoms and enhance overall functioning. CPT is acknowledged as a primary treatment option for PTSD, supported by various global mental health organizations. Its effectiveness is well-documented, though individual responses can differ, necessitating ongoing monitoring of therapeutic progress. CPT demands active participation from patients in questioning their thoughts and beliefs, which can be emotionally intensive. Continued research efforts aim to improve CPT’s accessibility, patient engagement, and overall effectiveness. Adaptations for diverse groups and environments are also being explored to ensure its wider applicability and lasting impact in PTSD treatment.
Prolonged Exposure (PE) Therapy is among the most effective PTSD treatments available, with substantial research backing and it is widely recommended as a primary treatment for PTSD by numerous mental health organizations and the Institute of Medicine. It is particularly useful for complex cases, including those with comorbid conditions. The therapy involves patients repeatedly recounting their traumatic experiences in a controlled, therapeutic setting to lessen the impact of trauma-related memories and reduce PTSD symptoms. It teaches individuals that trauma reminders are not necessarily threatening, and that emotional distress is both manageable and temporary. PE therapy generally spans 8 to 15 sessions, with each session lasting approximately 90 minutes. Long-term results indicate that many patients may no longer meet the criteria for PTSD years after completing PE therapy. However, about one-third of patients may still exhibit symptoms after treatment, and addressing dropout rates is a critical concern. Current research aims to enhance PE therapy's effectiveness and accessibility, incorporating neuroscience insights and making adaptations to suit a broader range of patients, including those less responsive to traditional methods.
Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic technique designed to alleviate the distress from traumatic memories. It combines the recall of distressing events with bilateral sensory input, such as side-to-side eye movements or hand tapping. Initially developed for PTSD, EMDR now also treats anxiety, depression, and addiction. EMDR therapy is known for facilitating rapid improvements, often quicker than conventional therapies. It allows patients to process traumatic memories with minimal verbal discussion or re-experiencing of the events. The method focuses on processing and moving beyond traumatic experiences, adaptable to intensive or regular weekly sessions while maintaining its effectiveness. EMDR is recognized as a "best practice" for PTSD treatment by key organizations including the U.S. Department of Veterans Affairs and the World Health Organization. Its efficacy in reducing PTSD, depression, and anxiety symptoms is well-supported by research. Although effective and generally well-tolerated, some scepticism remains because the neural mechanisms behind EMDR aren’t well understood. Current research is focused on understanding and improving and proving the effectiveness of EMDR for various disorders, solidifying its status as a well-supported treatment option.
Other treatments being investigating
While these evidence-based treatments are in common use to treat PTSD, they are by no means the only ones. The recurring cycles of conflict and terrorism have highlighted the need for a range of more effective solutions. Many professionals are arguing for the need to adapt our standard practices to the unique pressures of our environment and mixed methods and other investigative approaches are currently under study to validate and enhance the effectiveness of those therapies further.
This research continues to expand the range of therapeutic options and deepen our understanding of how these treatments work.
Special thanks to Prof. Jonathan Huppert for his invaluable support and expertise in shaping the content of this blog.
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