Health Care

Kevlar for the Mind: Talk therapy’s promise for PTSD

Developing effective treatments for veterans suffering from post-traumatic stress disorder is a main focus of psychiatric research. To date, results have been modest at best. This is unfortunate and disappointing considering the millions of dollars that have been funneled into civilian and governmental research labs.

Popular trauma-focused talk therapies provide relief for many, but countless others continue to struggle with nightmares, flashbacks and social anxiety. Exposure therapy requires the patient to recount the most distressing aspect of a traumatic event in order to "desensitize" to it. This is often seen by individuals as too difficult and leads to high dropout rates. The homework assignments associated with cognitive therapy are seen by many as unwieldy. And if the assignments are not completed outside of therapy, improvement is slow if it occurs at all.

Medications are no better. In fact, they're probably worse. Psychiatrist Richard Friedman eloquently made this point in a recent New York Times op-ed piece titled "Psychiatry's identity crisis."

Friedman noted how psychiatric medications today are no more effective than their pharmacological cousins of the 1950s and 1960s. And even though the side effects of today's meds are less severe, they are still many and result in poor compliance. Plus, as highlighted by Friedman, most people would rather participate in psychotherapy than take a pill. The good news is that researchers are studying interpersonal psychotherapy for PTSD. Preliminary results for interpersonal psychotherapy with trauma patients have proven strong.

Psychiatry and psychology researchers compared interpersonal psychotherapy, prolonged exposure therapy and relaxation therapy in 110 unmedicated patients; results were reported in the May 2015 issue of the American Journal of Psychiatry. Fewer people dropped out of the interpersonal psychotherapy group, indicating greater tolerance of the treatment. Furthermore, a greater percentage of patients showed improvement compared to the other therapies.

Results were even more impressive when depression was a factor. Depressed patients were nine times more likely to drop out of exposure therapy compared to interpersonal psychotherapy.

As we continue to fund medication and psychotherapy research for PTSD, a portion of these monies should be funneled to researchers studying interpersonal psychotherapy. So far, it has shown that it is as effective as other mainstream talk therapies and medication. And since it is better tolerated by those receiving it, fewer people will drop out of treatment.

For more information on interpersonal psychotherapy, visit here.

Bret A. Moore, Psy.D., is a board-certified clinical psychologist who served two tours in Iraq. Email him at This column is for informational purposes only and is not intended to convey specific psychological or medical guidance.

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