Since the end of the Vietnam War and associated increase in recognition of Posttraumatic Stress Disorder (PTSD) as a major mental health concern, a significant amount of attention and research has been geared towards developing effective treatment protocols for PTSD. The last 30+ years have given us four evidence-based treatments, which vary in approach but share one common feature, exposure to the memory of the traumatic event. 

At present, the four identified evidence-based treatments for PTSD are Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), Narrative Exposure Therapy (NET), and Prolonged Exposure Therapy (PET). No current research supports the use of any one of these treatments over any other, and no consistent research can demonstrate that what makes the treatments different from one another has any added value. Which means that, when you are searching for a trauma-focused treatment provider, it is important your provider is trained in trauma-focused therapy in general as opposed to any specific one of the treatments identified above.

As a trauma-focused therapist, I have found that each of these treatment modalities "fits" an individual differently. CTP treatment combines the creation of a trauma narrative with identification of unhelpful thoughts related to that experience. During the course of treatment, you write out your memory of a traumatic event, discuss and write down thoughts that have emerged or changed as a result of the event, and then challenge any thoughts that are maintaining anxiety or unhelpful behaviors. CPT was originally developed as a treatment for people who had survived a single rape, and I find that, true to its origins, it is my treatment of choice if you have survived a discrete number of sexual assaults. 

EMDR is a treatment that combines holding a memory of a trauma experience in your mind while looking at an external cue (e.g., your therapist's finger, a light). This is the only evidence-based treatment that does not always entail writing or speaking your memory out loud. It does, however, require that you bring the memory to mind and spend time with it. While I have not conducted EMDR personally, I have spoken with other providers who say that it is extremely effective. 

Narrative Exposure Therapy contextualizes traumatic events within the overall narrative of a person's life. During this treatment, you create a timeline of your life, including both positive and negative memories, and then write out, in detail, the memory of each traumatic event experienced. NET was originally designed for people who have suffered multiple or chronic traumatic events, usually as a result of cultural or political reasons. My original training in NET was in the context of working with asylum seekers and refugees. I have since used NET with individuals who experienced chronic abuse or exposure to domestic violence as children, grew up or live in dangerous neighborhoods, or have been in domestically violent relationships. My experience has shown me that the ability to integrate traumatic memories within the context of positive events is extremely helpful. Therefore, I do find that this is my treatment of choice if you have experienced multiple traumatic events. 

Prolonged Exposure Therapy requires the writing of a detailed trauma narrative and then (exactly as it sounds) repeatedly re-reading that narrative in a safe and controlled environment. Traditional PET requires 90-minute sessions so that you can experience a strong peak in anxiety and then a significant decrease in that anxiety. PET was originally designed for veterans who tend to experience a high level of reactiveness to reminders of their traumatic experiences (e.g., have extreme terror when a car backfires because it triggers a war-related memory). I have used PET both with veterans and individuals in the community who experience acute anxiety in response to any reminders of their trauma but are not necessarily affected by thoughts that were changed as a result of that event. 

The take home point of all of these treatments is that there are four different, scientifically-based treatments for PTSD that all include some degree of exposure to the memory of the traumatic event. Please, if you are a survivor, do not go without treatment for any reason, but certainly do not forgo getting help because a provider does not do all four of these. Find a provider who does at least one and go see them! Your memory does not have to control your life. 

I am trained in three of the four of these treatments. Please contact me if you would like treatment and services, but if you don't want to come see me, go see someone else qualified.