PTSD Treatment Categories

This blog post explores the most common PTSD treatment categories. I'll cover:

  • Coping and Supportive Management Treatments
  • Strengthening and Tone Work Treatments
  • Healing and Resolution Treatments
  • Medication-Assisted Treatments
  • Rebuilding and Establishing a Meaningful Life
  • Technology-Assisted Treatments
  • Bottom-Up Treatments
  • Dual Focus Treatments
  • Mixed Approach Treatments

Coping and Supportive Management Treatments

  • Copying and supportive management treatments help PTSD survivors adapt to their symptoms and minimize life disruption. 
  • The most common treatments in this category are relaxation training, breath training, support groups, peer to peer intervention.
  • Medication is used in this category to control specific symptoms related to PTSD such as depression, anger, anxiety, sleep disturbance, nightmares.
  • For most PTSD survivors, the relief experienced by coping techniques does not last past the last dose of these treatments.

Strengthening and Tone Work Treatments

  • Strengthening and Tone Work interventions help PTSD survivors tolerate negative affect and physical discomfort.
  • This treatment ensures therapy is productive, and PTSD survivors do not retreat into avoidance or substance use to manage overwhelming symptoms.
  • The skills taught in this category are referred to as Affect Regulation or Distress Tolerance.
  • These interventions are often used to prepare a PTSD survivor for the more challenging work of healing and trauma resolution.
  • Many types of affect regulation therapies and bodywork techniques begin in this category and cross into the category of healing or resolution.

Healing and Resolution Treatments

  • Healing and Resolution techniques directly attempt to return the brain to pre-trauma functioning or allow a new integration of the trauma, most often by directly dealing with traumatic memories in session.

Medication-Assisted Treatments

  • New interventions have been emerging that allow psychotherapy to be more productive.
  • These take the form of pharmacologically-based interventions paired with psychotherapy.
  • D-cycloserine
    • This medication is building support for being able to block traumatic re-experience during recall.
    • When combined with therapy, this allows for faster processing to resolve painful affect.
    • D-cycloserine helps PTSD survivors let go of fear.
  • MDMA (Methylenedioxymethamphetamine)
    • MDMA began clinical trials.
    • MDMA is typically combined with exposure or interpersonal therapy.
    • MDMA is administered before therapy, which triggers intensely pleasurable feelings.
    • Once the PTSD survivor is in a relaxed state, they work through the traumatic events in psychotherapy.

Rebuilding and Establishing a Meaningful Life

  • Interventions that seek to move a client back to a productive life are occupational therapy, spiritual explorations, and interpersonal or vocational interventions.

Technology-Assisted Treatments

  • Virtual Reality is primarily a version of prolonged exposure. Evidence is beginning to support this as a possible intervention for PTSD when combined with PE or other types of exposure intervention.
  • Telephonic and Remote Video interventions are increasingly being used to allow traditional interventions to reach clients who cannot easily travel to the clinic for service.

Group Interventions

  • Cognitive Processing Therapy is the most researched group intervention. Research supports the positive impact of behavioural family group interventions for child abuse trauma.
  • Present Centred Group Therapy helps group members separate PTSD symptoms and trauma experience from their present life. This group approach has considerable research support.

Top-Down Treatments

  • These treatments use a cognitive processing technique to manage trauma.
  • The most common of these is cognitive-behavioural therapy.
  • A variation of CBT designed explicitly for trauma is Cognitive Processing Therapy (CPT), which targets both trauma recall and challenging of disordered thinking.

Bottom-Up Treatments

  • These treatments use body-based interventions to introduce incompatible sensations or spatial awareness as a tool for conflicting information.
  • A partial list of these interventions with research support includes yoga, mindfulness or moving meditation, Tai chi/Qi Gong, somatic experiencing, somatic therapy, acupuncture/acupressure.
  • Multiple Studies with children showed a combination mind-body approach is an effective treatment.
  • Neurofeedback or EEG Biofeedback is one of the oldest techniques with research support.
  • Current research shows impressive results with higher symptom resolution for bottom-up therapies.

Mixed Approach Treatments

  • These techniques use a combination of bottom-up and top-down treatments.
  • Hypnosis, cognitive reframes, guided imagery, and relaxation are mixed in this treatment.  
Available Here