Do all psychological treatments really work the same in posttraumatic stress disorder?

Description

A recent meta-analysis by Benish, Imel, and Wampold (2008, Clinical Psychology Review, 28, 746-758) concluded that all bona fide treatments are equally effective in posttraumatic stress disorder (PTSD). In contrast, seven other meta-analyses or systematic reviews concluded that there is good evidence that trauma-focused psychological treatments (trauma-focused cognitive behavior therapy and eye movement desensitization and reprocessing) are effective in PTSD; but that treatments that do not focus on the patients' trauma memories or their meanings are either less effective or not yet sufficiently studied. International treatment guidelines therefore recommend trauma-focused psychological treatments as first-line treatments for PTSD. We examine possible reasons for the discrepant conclusions and argue that (1) the selection procedure of the available evidence used in Benish et al.'s (2008)meta-analysis introduces bias, and (2) the analysis and conclusions fail to take into account the need to demonstrate that treatments for PTSD are more effective than natural recovery. Furthermore, significant increases in effect sizes of trauma-focused cognitive behavior therapies over the past two decades contradict the conclusion that content of treatment does not matter. To advance understanding of the optimal treatment for PTSD, we recommend further research into the active mechanisms of therapeutic change, including treatment elements commonly considered to be non-specific. We also recommend transparency in reporting exclusions in meta-analyses and suggest that bona fide treatments should be defined on empirical and theoretical grounds rather than by judgments of the investigators' intent.

Format

Journal

Language

English

Author(s)

Anke Ehlers
Jonathan Bisson
David M. Clark
Mark Creamer
Steven Pilling
David Richards
Paula P. Schnurr
Stuart Turner
William Yule

Original Work Citation

Ehlers, A., Bisson, J., Clark, D. M., Creamer, M., Pilling, S., Richards, D., Schnurr, P. P., Turner, S., & Yule, W. (2010, March). Do all psychological treatments really work the same in posttraumatic stress disorder? Clinical Psychology Review 30(2), 269?276. doi:10.1016/j.cpr.2009.12.001

Collection

Citation

“Do all psychological treatments really work the same in posttraumatic stress disorder?,” Francine Shapiro Library, accessed October 25, 2020, https://emdria.omeka.net/items/show/19566.

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