Thursday, March 19, 2009


Traumatic experiences can cause significant pyschological problems for large numbers of people. Not everyone is affected but it is estimated that 13% of people involved in car crashes and 19% of people who are victims of violent crime go on to suffer from acute stress disorder. Rates of acute post-traumatic stress disorder (PTSD), which is defined as PTSD symptoms for less than three months, vary from 23% of those involved in car crashes to 47% in rape victims. A third of people who develop acute PTSD go on to develop chronic PTSD, suffering symptoms for 6 years or longer. People have tried to develop interventions to prevent the development of chronic PTSD. One such intervention was psychological debriefing but this began to be questioned in the 1990s, little evidence was found for its effectiveness and many experts now advise against it. A review of 25 studies by researchers at Cardiff University found that trauma-focused cognitive-behaviour therapy (CBT) was more effective than doing nothing or supportive counselling for acute stress disorder and acute PTSD.

Roberts, Neil P. ... [et al] - Systematic review and meta-analysis of multiple-session early interventions following traumatic events American Journal of Psychiatry March 2009, 166(3), 293-301


mfurois said...

The research you quote compares CBT, or perhaps CPT, to no treatment or to "supportive therapy" which is clearly inadequate treatment. Therefore the purveyors of CBT/CPT show that their therapy is bettern than no treatment or poor treatment; hardly useful science.
Please advise your readers to review a solid meta analysis (Benish, et. al., 2007) found in Clinical Psychology Review, Volume 28. This replicates long standing findings that variables about the client, and the strength of the therapeutic relationship account for positive therapeutic change. The type of therapy used influences the outcome therapy only minimally.

John Gale said...

Thanks for your comment. I would agree that this research - in common with about 90% of journal articles in my opinion - is hardly earth-shattering which is why I gave the post the title 'CBT for PTSD' rather than, for example, 'CBT is miracle cure for PTSD.' I hope you would agree that I have stuck to the facts as reported in the study rather than getting carried away with the hype. I am not in a position to make a detailed critique of every study which is why I always try and give references so people can make their own minds up! I certainly have no axe to grind as far as CBT is concerned and would share many of your concerns about how it has come to dominate the 'evidence-based' agenda.
Best Wishes,