Advances in the Treatment of Posttraumatic Stress Disorder: Cognitive-Behavioral Perspectives

By Steven Taylor | Go to book overview

Chapter 14
A GLASS HALF EMPTY OR HALF
FULL? WHERE WE ARE AND
DIRECTIONS FOR FUTURE
RESEARCH IN THE TREATMENT
OF PTSD

Shawn P. Cahill and Edna B. Foa


INTRODUCTION

In 1992, Solomon, Gerrity, and Muff conducted a comprehensive survey of the published treatment outcome literature on posttraumatic stress disorder (PTSD) and found 11 randomized controlled studies investigating the efficacy of medication (5 studies) or psychotherapy (6 studies). They concluded there was [a modest but clinically meaningful effect] for medication (p. 633) and that [[s]tronger effects were found for behavioral techniques involving direct therapeutic exposure,] (p. 633) although they expressed concern about safety of exposure therapy, citing a case series by Pitman et al. (1991). Moreover, they called for more research before pronouncing any treatment as an effective, lasting treatment for PTSD. To that end, Solomon et al. made the following suggestions for future directions in research, (a) Comparisons between individual and combined treatments in order to [understand which components, in which combinations, result in treatment gains], (p. 637) and to specifically test the hypothesis that [flooding may prove to be most effective when combined with cognitive forms of therapy, designed to address irrational cognitions and provide the patient with coping skills] (p. 637). (b) Determination of the optimal conditions for each treatment approach, including such variables as duration and timing of treatment (e.g., whether

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