Overview of Evidence-Based Treatments for PTSD: Prolonged Exposure Therapy (PE) & Cognitive Processing Therapy (CPT)

90-360 minutes (10 minute break required every 90 mins)

Description

This training module broadly reviews the etiology of PTSD and evidence-based approaches to treat it, including PE and CPT. Special attention is given to the theoretical underpinnings of PE and CPT and how these protocols in particular address obstacles to the normal recovery process in individuals with PTSD, including military personnel. Videotaped case examples are used to highlight PE and CPT therapist skills and techniques. After a didactic portion, PE and CPT experts lead a panel discussion on similarities and differences between PE and CPT.

Outline

  1. History of PTSD in the Diagnostic and Statistical Manual (DSM)
  2. Relationship between trauma exposure & post-trauma difficulties
    1. Prevalence of trauma exposure
    2. DSM-IV criteria for PTSD
    3. DSM-IV criteria for Acute Stress Disorder (ASD)
    4. Relationship between ASD and PTSD
    5. Typical course of trauma reactions without intervention
  3. Etiological models of PTSD
    1. PTSD risk factors
    2. Neurobiological model of PTSD
    3. Cognitive-behavioral model of PTSD
    4. Special issues in military populations:
      1. Trauma exposure in OIF/OEF, combat stress reactions, prevalence and risk for PTSD
      2. Factors that mitigate combat stress reactions in OIF/OEF military members
  4. Etiological models & evidence based treatments for PTSD
  5. Theory underlying PE
    1. Classical conditioning
    2. Operant conditioning
    3. Fear structure and emotional processing
    4. 2 main factors involved in PTSD: avoidance of trauma cues and memory and distorted cognitions about danger and incompetence
  6. Overview of PE protocol
    1. 10 sessions, 90 minutes if possible, homework and recordings required, agenda /manual
    2. Main techniques: common reactions, breathing retraining, in-vivo exposure, imaginal exposure
    3. Rationale and procedures for in-vivo and imaginal exposure and procedures
    4. Use of Subjective Units of Distress (SUDs), self-report measures during course of treatment and pre & post treatment
  7. CPT outcome research overview & theory underlying CPT
    1. CPT treatment outcome findings
    2. Overview of PTSD as a disorder on non-recovery
    3. Cognitive theory of PTSD, cognitive distortions and CPT treatment rationale/approach
  8. Overview of CPT protocol
    1. Patient readiness and contracting for CPT
    2. Identifying & exploring the impact of cognitive distortions in PTSD; teaching patients cognitive theory of emotions
    3. Trauma processing in CPT
    4. Teaching patients how to challenge & change cognitive distortions
    5. Exploring trauma-related themes: safety, trust, power/control, esteem, intimacy

Learning Objectives

  1. To gain knowledge about the evidence-based etiological models of PTSD.

  2. To identify evidence-based treatments for PTSD and research to support them.

  3. To become familiar with the theory and evidence supporting PE and CPT and the basic approach each uses to treat PTSD.

Notes

Participants are asked to submit questions for the panel discussion at the end of the training module ahead of time on index cards.