Effectiveness of an intensive treatment programme combining prolonged exposure and eye movement desensitization and reprocessing for severe post-traumatic stress disorder

Abstract

Background: There is room for improvement regarding the treatment of severe post-traumatic stress disorder (PTSD). Intensifying treatment to increase patient retention is a promising development. Objective: The aim of this study was to determine the effectiveness of an intensive trauma-focused treatment programme over 8 days for individuals suffering from severe PTSD. Method: Treatment was provided for 347 PTSD patients (70% women; mean age = 38.32 years, SD = 11.69) and consisted of daily sessions of prolonged exposure and eye movement desensitization and reprocessing (EMDR) therapy (16 sessions in total), physical activity, and psycho-education. All participants had experienced multiple traumas, including sexual abuse (74.4%), and suffered from multiple comorbidities (e.g. 87.5% had a mood disorder). Suicidal ideation was frequent (73.9%). PTSD symptom severity was assessed by both clinician-rated [Clinician Administered PTSD Scale (CAPS)] and self-report [PTSD Symptom Scale Self Report (PSS-SR) and Impact of Event Scale (IES)] inventories. For a subsample (n = 109), follow-up data at 6 months were available. Results: A significant decline in symptom severity was found (e.g. CAPS intention-to-treat sample Cohen’s d = 1.64). At post-treatment, 82.9% showed a clinically meaningful response and 54.9% a loss of diagnosis. Dropout was very low (2.3%). Conclusions: Intensive trauma-focused treatment programmes including prolonged exposure, EMDR therapy, and physical activity can be effective for patients suffering from severe PTSD and are associated with low dropout rates.

A decennial review of psychotraumatology: what did we learn and where are we going?

“…Since 2010, we have seen innovations in the modes of treatment delivery, which have increased patient choice and access to treatment. For example, we have learned that trauma-focused psychological treatments can be safely and effectively delivered in an intensive format (Ehlers et al, 2014;Hendriks, de Kleie, Broekman, Hendriks, & van Minnen, 2018;Méndez, Nijdam, June Ter Heide, van der Aa, & Olff, 2018;Van Woudenberg et al, 2018). We have also seen that therapist input can be shortened through the use of self-study modules (Wild & Ehlers, 2010) and that rotation of therapists is feasible (Van Minnen et al, 2018).…”

Improvements in cardiorespiratory fitness are not significantly associated with post-traumatic stress disorder symptom reduction in intensive treatment

“…In accordance with these positive results, new intensive trauma-focused treatments have been developed that incorporate physical activity together with PE and EMDR therapies. These treatments have shown low dropout rates and strong reductions in PTSD symptoms within a short time frame of 5 to 8 treatment days (Van Woudenberg et al, 2018;Zepeda Méndez, Nijdam, Ter Heide, Van Der, & Olff, 2018). However, the relation between physical activity and PTSD treatment outcome is not yet clear.…”

Long-term posttraumatic stress disorder in mine workers after a coalmining disaster

“…Identification of another psychiatric condition concurrent with PTSD is not rare [33][34][35][36] . In our study, the rate of presence of comorbid psychiatric disease was found to be significantly higher in participants with a positive PTSD screen than in those with a negative PTSD screen; however, this was not found to be a risk factor for PTSD.…”