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Dissemination of Evidence-Based Treatments for PTSD: Barriers and Accomplishments

Posttraumatic stress disorder (PTSD) presents as a significant public health challenge because of its pervasive effects on mental health, physical health, and psychosocial problems. A recent review published in Psychological Science in the Public Interest, evaluates the effectiveness of prolonged exposure (PE) and cognitive behavior therapy (CBT) for individuals with PTSD. Although studies indicate that these treatments are efficacious for various populations, many individuals with PTSD do not receive evidence-based treatments (EBTs). The present review investigates barriers to be addressed in order to promote dissemination of EBTs for PTSD in developed and developing countries. Specifically, the authors review examples of dissemination models, discuss possible solutions, and suggest future steps in disseminating EBTs for PTSD. Improved dissemination of EBTs for PTSD is necessary in order to increase accessibility of successful treatments.

Foa, E. B., Gillihan, S. J., & Bryant, R. A. (2013). Challenges and successes in dissemination of evidence-based treatments for posttraumatic stress: Lessons learned from prolonged exposure therapy for PTSD. Psychological Science in the Public Interest, Supplement, 14(2), 65-111.

Older Veterans with Post-traumatic Stress Disorder Helped by CBT

NewStudy-Graphic-72x72_edited-3Medscape: According to a pilot study presented at the Anxiety Disorders Association of America 2009 Annual Conference, older veterans suffering from post-traumatic stress disorder (PTSD) and related symptoms of depression and anxiety – which can persist for decades – may benefit from prolonged exposure therapy (a form of cognitive behavioral therapy). Twelve sessions included “in vivo experience, in which patients are exposed to fears out in the world, and imaginary exposure.”

Measures of efficacy included a Clinician-Administered PTSD Scale (CAPS); after treatment, patients showed a significant reduction in mean CAPS score and 75% no longer met PTSD criteria. Patients showed clinical improvement in most PTSD symptoms along with individual symptoms of avoidance and hyperarousal. Additionally, Beck Depression Inventory (BDI) and other measures showed “clinically significant improvement in both depression and anxiety.” The study author noted that after the treatment, the men were able to “do things they hadn’t done in years.”

These findings are particularly promising because they call into question the “dogma” that older adults cannot tolerate or could be harmed by exposure therapy.

According to the study author, “There are lots of people with PTSD who fought in prior wars or who have the condition for other reasons, who have pushed it aside and coped pretty well throughout their lives. Then a spouse dies, they retire or become medically ill, and their PTSD is something they no longer can put aside, and they need help. We need to know how to treat these people.”

The author is planning a randomized clinical trial in 100 older adults with PTSD.

Study author: S. R. Thorp