Trauma · Treatment guide
Post-Traumatic Stress Disorder
Re-experiencing, avoidance, negative cognition/mood, and hyperarousal following a traumatic event.
In this guide
Overview
Trauma-focused psychotherapies outperform medication for PTSD. Three first-line options have comparable efficacy; choice often depends on client preference and avoidance level. Stabilization and resourcing precede reprocessing in complex trauma.
First-line treatments
- PE — Prolonged Exposure for PTSD
Prolonged Exposure — imaginal + in vivo exposure to memory and reminders.
- CPT — Cognitive Processing Therapy
Cognitive Processing Therapy — 12 sessions targeting trauma-related stuck points.
- EMDR — Eye Movement Desensitization and Reprocessing
8-phase protocol using bilateral stimulation to reprocess the memory.
Also consider
Cautions
- Always resource before reprocessing; build a stable window of tolerance.
- Active suicidality, severe dissociation, or unsafe living situations require stabilization first.
Worked cases
- Post-traumatic stress disorder (single-incident)
PTSD after a serious motor vehicle accident 14 months prior; avoiding driving, intrusive imagery, sleep disruption.
- Prolonged grief disorder
Three years after loss of adult child; pervasive yearning, avoidance of reminders, identity disruption.
- Complex PTSD
Chronic relational childhood abuse; pervasive shame, affect dysregulation, attachment disruption, dissociation under stress.