Dissemination of exposure therapy in the treatment of posttraumatic stress disorder. Journal of Traumatic Stress, 19(5), 597-610

Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 10/2006; 19(5):597-610. DOI: 10.1002/jts.20173
Source: PubMed

ABSTRACT Since the introduction of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1980), considerable research has demonstrated the efficacy of several cognitive-behavioral therapy (CBT) programs in the treatment of chronic PTSD. Among these efficacious treatments is exposure therapy. Despite all the evidence for the efficacy of exposure therapy and other CBT programs, few therapists are trained in these treatments and few patients receive them. In this article, the authors review extant evidence on the reasons that therapists do not use these treatments and recent research on the dissemination of efficacious treatments of PTSD.

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Available from: Shawn P Cahill, Aug 17, 2015
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    • "Because of the complex symptomatology often found in patients with PTSD following CSA (Cloitre et al., 2009), this concern is especially salient in the treatment of this population. A number of authors have emphasized that there is currently no evidence to suggest that exposure-based treatment is related to symptom worsening on a large scale (e.g., Cahill et al., 2006; Van Minnen, Harned, Zoellner, & Mills, 2012). Only recently, an article on symptom worsening in a large sample of PTSD patients (n 0361) reported an overall improvement on PTSD and showed that worsening of PTSD symptoms was virtually non-existent from pre-to post-treatment assessments (Jayawickreme et al., 2014). "
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    ABSTRACT: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD). However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD.
    European Journal of Psychotraumatology 09/2014; 5: 24470. DOI:10.3402/ejpt.v5.24470 · 2.40 Impact Factor
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    • "Further, when symptom worsening occurred, it was not associated with either worse treatment outcomes or with increased dropout rates. Effective dissemination efforts for exposure therapy will need to confront misinformation about potential harm with discussion of research findings that debunk such myths (Cahill et al., 2006; Cook et al., 2004). Therapists may also hold beliefs that may lead them to doubt the applicability of RCTs to clinical practice (Gunter & Whittal, 2010). "
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    ABSTRACT: Over the past 9 years approximately 2 million U.S. military personnel have deployed in support of Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in and around Afghanistan. It has been estimated that 5-17% of service members returning from these deployments are at significant risk for combat-related posttraumatic stress disorder (PTSD). Many of these returning war veterans will seek medical and mental health care in academic health centers. This paper reviews the unique stressors that are related to the development of combat-related PTSD. It also reviews evidence-based approaches to the assessment and treatment of PTSD, research needed to evaluate treatments for combat-related PTSD, and opportunities and challenges for clinical psychologists working in academic health centers.
    Journal of Clinical Psychology in Medical Settings 06/2011; 18(2):164-75. DOI:10.1007/s10880-011-9238-3 · 1.49 Impact Factor
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    • "As a set of therapeutic techniques to help PTSD clients safely confront and master feared situations, memories, or images, exposure effectively counters avoidance, which allows those with PTSD to rebuild routine into their previously restricted daily lives (Foa, 2006). As a therapy, prolonged exposure constitutes a highly effective treatment for PTSD (Cahill et al., 2006; Foa et al., 2005; Foa, Keane, & Friedman, 2000), including PTSD in female veterans and active-duty military personnel (Schnurr et al., 2007). "
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    ABSTRACT: PURPOSE. This paper examines the experience of posttraumatic stress disorder (PTSD) in a female veteran of Operation Iraqi Freedom, including the barriers to treatment she encountered in an outpatient psychiatry clinic. DESIGN AND METHODS. Case report data were obtained through review of records and interviews with a veteran combat nurse diagnosed with chronic PTSD. CONCLUSIONS. Sex differences in PTSD are controversial, but PTSD in female military veterans is a significant problem. Gender may complicate diagnosis and treatment. This case report discusses these issues and invites further research. PRACTICE IMPLICATIONS. Advanced practice psychiatric nurses increasingly will see female veterans with PTSD in their practices.
    Perspectives In Psychiatric Care 10/2009; 45(4):278-91. DOI:10.1111/j.1744-6163.2009.00230.x · 0.71 Impact Factor
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