People who develop acute stress disorder during or soon after a traumatic event are likely to go on to develop post-traumatic stress disorder (PTSD) which is associated with other mental and physical illnesses, a reduced quality of life and increased health-care costs. Exposure therapy, in which recent trauma survivors are instructed to relive the troubling event, and cognitive restructuring, which focuses on changing maladaptive thoughts and responses to a traumatic event, have been used as interventions to prevent people with acute stress disorder going on to develop full-blown PTSD. However, there is evidence that some clinicians do not use exposure therapy because it causes distress for recent trauma survivors. An Australian study with 63 participants compared those taking part in exposure therapy with those receiving cognitive restructuring. After the treatment fewer people in the exposure-therapy group (37% vs 63%) met the criteria for PTSD and more (47% vs 13%) met the criteria for full remission. Despite concerns that patients would not be able to manage the distress elicited by prolonged exposure there was no difference in drop-out rates between the two groups.
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