Management of post-traumatic stress disorder
Innovative approaches, including digital interventions such as PTSD Coach and virtual reality exposure therapy, are expanding access to care and further diversifying treatment options.
[3] Trauma-focused cognitive-behavioral therapy (TF-CBT) was developed by Anthony Mannarino, Judith Cohen, and Esther Deblinger in the mid-1990s to help children and adolescents with PTSD.
Individuals work through the memories of the trauma in a safe and structured environment, trying to correct negative cognitions and thoughts while also performing gradual exposure to triggers.
[10] In recent years, psychologists have tested the effectiveness of culturally modified TF-CBT approaches with different communities, such as unaccompanied child migrants and women in war-torn countries.
[8] TF-CBT has repeatedly demonstrated effectiveness and is currently recommended as a first-line treatment for PTSD by the American Psychological Association,[6] Australian Centre for Posttraumatic Mental Health,[13] and the National Institute of Clinical Excellence (NICE).
Thus, three goals drive cognitive therapy for PTSD: One specific practice is imagery rescripting where the therapist guides the patient to reimagine their traumatic memory in a way that gives them control so that they can create new outcomes.
CPT is founded on the principle that generally, individuals can gradually recover from traumatic events over time, but in those diagnosed with PTSD, this recovery pathway is impaired.
The bilateral stimulation facilitated by EMDR "shifts the brain into a memory processing mode", reintegrating the traumatic events with more positively reinforced cognitions.
[15] Exposure therapy involves exposing the patient to PTSD-anxiety-triggering stimuli, with the aim of weakening the neural connections between triggers and trauma memories (aka desensitization).
One specific study with promising results, analyzed a sports-oriented OT intervention using surfing to help veterans with PTSD return to civilian life.
[54] Positive psychology coaching has been used as PTSD treatment, described as a strengths-focused method centered around reducing arousal states, meeting goals, and cultivating self-control.
[60] SSRIs and SNRIs are recommended as the first-choice medication for people with PTSD by both the VA (US Department of Veteran Affairs) and APA (American Psychological Association).
[69] In the recent decade, alternative and complementary treatments have shown increasing promise in treating people with post traumatic stress disorder and have gained general popularity.
[76] The evidence for this practice are based in the stimulation of the "autonomic nervous system, and the prefrontal as well as limbic brain structures, making it able to relieve the symptoms of PTSD".
[80] The goal of animal-assisted intervention is to improve a patient's social, emotional, or cognitive functioning and literature reviews state that animals can be useful for educational and motivational effectiveness for participants.
[84] Various studies, as well as lots of anecdotal evidence, have shown reduction in PTSD symptomatology with the use of service dogs and canine therapy.
More research is needed before the American Psychological Association can list somatic therapy as a recommended treatment, but initial evidence has found it to be effective.
The goal of this kind of treatment is not "adaptation" or cognitive restructuring of the individual to the prevailing cultural norm, "but rather spiritual transformations and accompanying shifts in collective identity, purpose, and meaning making.
Researchers at the Stress-response Syndromes Lab at the University of Zurich, Switzerland, use the historical contributions of the Swiss psychologist Carl Gustav Jung to develop culturally sensitive treatments like symbolism and different myth stories to treat PTSD.
Jung's psychology asserts that "the fundamental 'language' of the psyche is not words, but images...studying the trinity of myths, metaphors, and archetypes enhances clinical interventions and psychotherapy.
[97] "After the Kobe-Awaji earthquake in 1995...Japanese psychologists became acutely aware of the need to receive specialized training in the treatment of post-traumatic stress disorder (PTSD) as well as crisis intervention.
[107][108] The utilization of digital interventions is important because of barriers to seeking treatment, such as stigma, difficulties in scheduling, waitlist, and limited mental health resources.
[107] Another review examined different randomized controlled trials (RCTs) exploring telehealth, Internet-based interventions, virtual reality exposure therapy, and mobile apps for PTSD.
[114][115][116][117][118][119][120][excessive citations] One study found that most users accessed the app to manage symptoms through the use of a coping tool (e.g., cognitive restructuring).
[113] The broad dissemination to the general public for PTSD Coach has continued to be supported with an average usage of three times across three separate days with a duration of 18 minutes of use.
[120] Because of the increased access to smartphones, one study examined the global use of PTSD Coach in Australia, Canada, The Netherlands, Germany, Sweden, and Denmark.
[121] There are other factors, such as Internet anxiety, that moderated the relationship between digital intervention usage with recommendations of providing information about data security to help users feel supported.
[122] Recent research has shown that cannabis is beneficial for PTSD Treatment according to the VFW (Veterans of Foreign Wars) in those who receive doses with higher levels in THC.
[123] According to Mallory Lofl, a volunteer assistant professor of psychiatry at the UC San Diego School of Medicine, one of the biggest takeaways from this study is that veterans with PTSD can use cannabis at self-managed doses, at least in the short term, and not experience a plethora of side effects or a worsening of symptoms.
The stellate ganglion is treated with an injection of local anesthetic (numbing medicine) to block the sympathetic nerves located on either side of the voice box in the neck.
