PTSD AND THE SOCIAL SUPPORT
OF THE INTERPERSONAL
ENVIRONMENT: THE DEVELOPMENT OF SOCIAL
COGNITIVE BEHAVIOR THERAPY
Nicholas Tarrier and Anne-Louise Humphreys
Although case studies and uncontrolled trials can provide evidence for treatment efficacy, this evidence is generally regarded as weak and potentially suffers from bias. The randomized controlled trial (RCT) remains the [gold standard] for evaluating treatment efficacy (Doll, 1998). A number of RCTs have demonstrated that cognitive-behavioral treatments are efficacious in the prevention and treatment of posttraumatic stress disorder (PTSD) (see Foa, Davidson, & Frances, 1999). Treatments have been applied to prevent the development of PTSD and to alleviate PTSD once it has developed.
Without treatment, approximately 70% of people who reach criteria for acute stress disorder (ASD) will go on to meet criteria for PTSD (Harvey & Bryant, 1998; Holeva, Tarrier, & Wells, 2001). Cognitivebehavioral therapy (CBT) delivered within the first month after the trauma in subjects suffering from ASD can significantly reduce the number who subsequently develop PTSD (Bryant, Harvey, Dang, Sackville, & Basten, 1998; Foa, Hearst-Ikeda, & Perry, 1995). In chronic PTSD, clinical trials have demonstrated that exposure therapy (Foa, et al.,1999; Foa, Rothbaum, Riggs, & Murdoch,1991; Keane, Fairbanks, Caddell, & Zimmering, 1989; Marks, Lovell, Nashirvani, Livanour, & Thrasher, 1998; Paunovic & Ost, 2001; Tarrier, Pilgrim, et al., 1999), cognitive therapy