Table 4.
Common psychotherapies recommended in clinical guidelines for PTSD*.
| Psychotherapy | Description |
| Recommended Trauma-Focused Psychotherapies | |
| Prolonged Exposure (PE) | A manualized therapy, including trauma psychoeducation, breathing training, in vivo exposure, imaginal exposure (repeatedly recounting traumatic memories during sessions and listening to audio recordings of these recollections), and discussion of thoughts and feelings related to those exercises. Uses principles of extinction learning, habituation, and desensitization to ultimately challenge catastrophic expectations. |
| Cognitive Processing Therapy (CPT) | A manualized adaptation of CBT that focuses on discussion and cognitive reprocessing of key posttraumatic cognitive themes, such as safety, trust, power, control, self-esteem, and intimacy. Also addresses shame, guilt, and mistrust. |
| Trauma-focused Cognitive Behavioural Therapy (TF-CBT) and Cognitive Therapy (CT) for PTSD | Includes CBT principles combined with trauma processing, which usually involves imaginal or graded in vivo exposure. In some studies, this term includes trauma-focused cognitive therapy, which focuses on addressing excessively negative appraisals of trauma, its consequences, or one’s own responses to the trauma. |
| Eye Movement Desensitization and Reprocessing (EMDR) | Includes exposure to memories while applying a dual attention task, such as alternating eye movements or bilateral body tapping. Dual attention tasks are thought to tax working memory and thereby reduce vividness and emotionality of the memory. This facilitates processing and reconsolidation of new information into the memory. EMDR includes a desensitization phase, cognitive restructuring phase, and a phase that focuses on reducing bodily sensations associated with traumatic memories. |
| Narrative Exposure Therapy (NET) | Based on modifications to PE and TF-CBT, NET focuses on a person’s life narrative, including that related to the trauma and to positive events, improving coherence and contextualization of the traumatic experiences within a person's whole life and overall identity. Also includes elements of trauma exposure, including experiencing cognitive, emotional, and sensory elements of trauma responses in the present moment. |
| Brief Eclectic Psychotherapy (BEP) | A manualized approach combining elements of CBT, imaginal exposure, psychodynamic psychotherapy, and grief therapy. It emphasizes expression of trauma-related grief, as well as addressing anger, shame, and guilt, including making meaning of the traumatic experiences. It also includes a ritual of closure (e.g., writing a virtual letter to the perpetrator in the case of sexual trauma and burning it at the end of treatment). |
| Recommended Non-Trauma-Focused Psychotherapies | |
| Interpersonal Psychotherapy (IPT) | Time-limited treatment, developed for Major Depression and adapted for PTSD, focusing on relational aspects contributing to illness, such as complicated bereavement following a death, role dispute (conflict with an important person in the patient’s life), role transition (major life changes), and interpersonal deficits. |
| Present Centred Therapy (PCT) | Time-limited treatment focuses on increasing adaptive responses to current life stressors and difficulties that are directly or indirectly related to trauma symptoms. Includes common nonspecific psychotherapy techniques, such as psychoeducation, facilitating safety and hope, validation and support, expression of feelings, and problem-solving. Diaries are used to record problems of concern throughout the week. |
| Stress Inoculation Training (SIT) | Based on CBT, SIT involves helping people identify and track their stress and learn coping skills to better manage symptoms, such as deep muscle relaxation, cognitive restructuring, breathing exercises, assertiveness skills, thought stopping, and role play. |