Psychotherapies for PTSD in Women With Abuse Histories - July 1, 2010
Posttraumatic stress disorder (PTSD) resulting from chronic abuse in childhood, also called complex PTSD, responded to a two-stage treatment in a
study by Cloitre et al. In the first 8 weekly sessions, dialectical behavior therapy was used, first to help teach emotional regulation and then to enhance interpersonal skills. The next 8 weeks were devoted to analyzing maladaptive interpersonal relationships and reactions to narratives about the traumas. Substituting supportive therapy for these specific therapies in either the first or second 8 weeks decreased the effect significantly, which suggests that both skills training and reexposure to trauma are necessary for optimal response. Of the women who received both treatments, 27% had sustained remission, significantly greater than the women in the two control groups. Dr. Richard Bryant in an
editorial endorses emotional preparation of the women in the first 8 weeks, prior to exposure therapy, and notes the 6 months' sustained effect.