Psychotherapy for PTSD: An evidence-based guide to a theranostic approach to treatment

Prog Neuropsychopharmacol Biol Psychiatry. 2019 Jan 10:88:418-426. doi: 10.1016/j.pnpbp.2018.05.006. Epub 2018 May 18.

Abstract

Posttraumatic stress disorder (PTSD) is often a clinically complex disorder, frequently presenting with comorbid clinical conditions. Individuals with PTSD may also present with high-risk symptoms such as substance misuse and suicidal ideation. The clinical complexity of PTSD has precluded some clinicians from providing gold-standard trauma-focused treatment due to concern of iatrogenic effects. However, evidence to date suggests that trauma-focused treatments are safe and effective for PTSD even when higher-risk comorbidity presents. Occasionally, while some patients present with clinical concerns that may benefit from modifications to standard recommended treatment protocols, research suggests there are few absolute contraindications to trauma-focused treatment. The present manuscript provides a review of evidence-based assessment and treatment recommendations for PTSD. A clinical decision-making guide for PTSD across areas of clinical complexity is provided.

Keywords: Clinical decision making; Posttraumatic stress disorder; Psychotherapy; Trauma-focused treatment.

Publication types

  • Review

MeSH terms

  • Decision Making
  • Humans
  • Psychotherapy / methods*
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / therapy*