Beyond exposure alone: Brief eclectic psychotherapy for PTSD

The efficacy of psychotherapeutic and pharmacotherapeutic approaches in the treatment of PTSD can be regarded as empirically demonstrated. Overall, effect sizes seem to be higher for psychotherapy as compared with medication. Many well-controlled trials with a mixed variety of trauma survivors have demonstrated that CBT is particularly effective in treating PTSD. More specifically, exposure therapy currently is seen as the treatment modality with the strongest evidence for its efficacy. However dropout rates from studies of CBT (including EMDR) usually are around 20 percent. Up to 58 percent of patients who completed CBT are still diagnosed with PTSD at posttreatment assessment. Furthermore, only 32-66 percent of patients included achieved good end-state functioning. There is a need to have treatment protocols based on CBT which meet more the expectations of traumatized clients. The 16-sessions Brief Eclectic Protocol (BEP) originally developed for police officers with PTSD proved to be effective in two randomized controlled trials and has been accepted in the NICE-Guidelines (2005). The second trial also showed effectivity on biological data. A trial in Zurich is still running. BEP encompasses apart from a slightly different form of exposure psychoeducation at the start (with the partner present), the use of letter writing to express angry feelings, the use of memorabilia and 12 sessions for the domain of meaning, how it changes the view on the world and on the person his or herself. It is ended with a farewell ritual. The dropout rate is lower compared to the traditional CBT. In the workshop the protocol will be presented, discussed and parts of it will be trained. www.

Conference

English

Berthold Gersons
Ulrich Schnyder

Gersons, B., & Schnyder, U. (2007, November). Beyond exposure alone: Brief eclectic psychotherapy for PTSD. Presentation at the International Society for Traumatic Stress 23rd Annual Meeting, Baltimore MD