Last week, I attended a well orchestrated day long conference on treating people with Post Traumatic Stress Disorder (PTSD). Organized by Dr. Rex Swanda from the New Mexico VA, the content of the conference primarily focused on therapeutic practices that have been studied and found to be effective in treating those who suffer from this disorder. Treatments that are considered evidence based have been subjected to at least several independent research studies, compared to other types of treatment, or to no treatment. Here is an abbreviated description of PTSD.

PTSD can occur when people suffer or witness a traumatic event in which they are threatened with death, injury, or physical violation. During the time of the trauma these people respond with horror, fear, or helplessness. The symptoms of PTSD include some of the following:

• Re-experiencing the trauma: through dreams, flashbacks, unwanted thoughts, or distress when reminded of the trauma.
• Numbing or avoiding: attempts to avoid situations, triggers, or thoughts about the trauma, feelings of detachment from others, loss of interest in activities, beliefs that their lives will be short, and restricted emotions.
• Hyperarousal: problems with sleep, easily irritated or angry, problems concentrating, and jumpiness.

If you have concerns that you or someone you care about has PTSD, please consult with a mental health professional for a diagnosis and treatment plan.

Now, back to the conference. There were multiple sessions that mostly reviewed the effective treatments for PTSD. Not surprisingly the therapies that work are based on mixtures of cognitive and behavioral therapies. These approaches have stood the test of time and science. Cognitive Behavioral Therapy (CBT) has been used to successfully treat a wide range of emotional and behavioral problems.

It’s fun when the conference planners inject a bit of controversy to keep the audience awake, especially after lunch. So I looked forward to the speaker, a psychologist well known for his narrative ability, humor, and intelligence. I was riveted by his stories, but disappointed when he slid into the sad old tale of how empirically validated therapies are woefully insufficient for those with severe trauma. His arguments were dated and dismissive. This same argument has been made for the past several decades. Ostensibly, cognitive behavioral therapies don’t address critically important culture differences, early developmental issues, individual differences, and fail to include warmth, empathy, and concern for clients.

It was too bad that the speaker did not stay at the conference to hear Dr. Evelyn Sandeen, also from the VA, discuss the difference between evidence based treatments and evidence based practice. In her talk she described how in practice, we tailor the treatment to the individual. Therefore, good practice requires a warm, nonjudgmental, supportive therapeutic relationship along with close attention to the client’s background, personality, and individual needs. A good cognitive behavioral therapist takes all of these factors into consideration while delivering validated treatments in an individualized, sensitive, and skillful manner.

I truly appreciate interesting conferences and all of the work that goes into organizing and producing them. Thanks to the New Mexico Psychological Association for consistently delivering quality continuing education!

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Prof.Lakshman (October 18, 2009)

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    Last reviewed: 18 Oct 2009