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Cognitive Therapy Relieves PTSD for Many

Although both group and individual therapy can ease post-traumatic stress disorder (PTSD) symptoms in active-duty military service members, individual therapy relieved PTSD symptoms better and quicker, according to a study led by a Duke University School of Medicine researcher.

The randomized clinical trial is the largest to examine an evidence-based treatment for active-duty military service members, with 268 participants from the U.S. Army’s Fort Hood.

The study analyzed the effectiveness of six weeks of cognitive processing therapy (CPT), and found that nearly half the participants in one-on-one therapy improved so much they no longer carried a PTSD diagnosis. Almost 40 percent of the participants in group sessions also dropped their PTSD diagnoses after six weeks.

“For some of the participants, you can see a change just by looking at them-as though they have been unburdened,” said Patricia Resick, PhD, the study’s lead author, who developed CPT in the 1980s for victims of rape and other interpersonal trauma and is now a professor of psychiatry and behavioral sciences at the Duke University School of Medicine.

“Some people think you have to go to therapy for years to address PTSD, but in this large-scale clinical trial with CPT, we saw a large percentage of patients show significant improvements and even recover from PTSD in a matter of weeks,” Resick said.

CPT examines how an individual thinks about a traumatic event and how that affects their emotions, Resick said.

“We look at what people have been saying to themselves about the trauma, which in people with PTSD can be distorted,” Resick said. “Many of them think there’s something they could have done differently to prevent the trauma. We teach them how to examine their thoughts and feel their natural emotions instead of feelings, such as guilt or blame, that may result from distorted thinking. We go back and look at the evidence. Once they think in a more balanced, factual way, their emotions and symptoms of PTSD subside.”

About half of the participants were assigned to group therapy, attending 90-minute sessions twice a week for six weeks. The other half met one-on-one with a therapist for 60-minute sessions twice a week for six weeks.

For all participants, PTSD-related symptoms such as nightmares, intrusive thoughts, or being easily startled improved. Overall, about 50 percent of participants experienced such improvement that they no longer met the criteria for a PTSD diagnosis, although many still had some symptoms, particularly trouble sleeping, Resick said.

Those who attended individual therapy saw more significant improvements in the severity of their PTSD symptoms and the improvements were seen more quickly, Resick said.

The study also showed that whether subjects received group or individual therapy, they had equal reductions in depression and suicidal thinking. These results continued through a six-month follow-up.

This article was adapted from information provided by Duke Health.

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