Cognitive-behavioral therapy for PTSD can be divided into two approaches: prolonged-exposure therapy (PET) and anxiety management. Foa has found PET to be the more effective of the two. It involves a set of techniques designed to help patients confront situations they fear in a safe and systematic way in order to change cognition about the traumatic event. The therapy is usually completed in 10 sessions, which can take place in as few as five weeks.
Among 96 female patients in a randomized trial, PET resulted in a 65% mean reduction in PTSD symptoms, compared to no reduction in symptoms among wait-listed controls (Foa et al., 1999). Between 90% and 95% of patients who receive the therapy improve by at least 30%. Only 10% of patients recieving PET do not respond to it, and many patients remit completely, Foa said.Detecting PTSD
Data from the National Comorbidity Survey show that between 50% and 70% of people are exposed to trauma in their lifetime, but only 8% to 12% of the population will go on to develop PTSD (Kessler, 2000).
Despite its prevalence, PTSD largely goes undetected, and patients often will not volunteer information about their exposure to trauma. People usually do not complain about PTSD per se, Davidson said. Instead they have somatic complaints, depression or sleep problems. They may abuse alcohol(Drug information on alcohol) and drugs or attempt suicide. They tend to present in emergency departments.
It is the doctor's task, Davidson said, to get behind these problems and find out whether PTSD is the cause.
Time is a critical factor in identifying and treating PTSD. Most recovery occurs in the first three months following a traumatic event and can continue through the first year, Foa said. Beyond that time, symptoms tend to persist, and PTSD becomes a chronic condition.
People who do not share their experiences and tend to push away thoughts of the trauma are more at risk for developing PTSD, Foa has found. Worse, they tend to interpret symptoms of PTSD as dangerous, so they try not to think about the event, afraid that thinking about it will cause more symptoms.
Not everyone exposed to trauma develops PTSD, a fact that can be forgotten in the moments following an event, when being traumatized can be equated with the need for therapy. "It's important to remember that most people are resilient," Foa said.