Effective Treatments for PTSD
Third Edition
Practice Guidelines from the International Society for Traumatic Stress Studies
HardcoverPaperbacke-bookprint + e-book
Grounded in the updated Posttraumatic Stress Disorder Prevention and Treatment Guidelines of the International Society for Traumatic Stress Studies (ISTSS), the third edition of this definitive work has more than 90% new content. Chapters describe PTSD assessment and intervention practices that have been shown to work and provide practical, real-world implementation guidance. Foremost authorities address the complexities of trauma treatment with adults, adolescents, and children in diverse clinical contexts. The book delves into common obstacles and ways to overcome them, when to stop trying a particular approach with a client, and what to do next. Special topics include transdiagnostic interventions for PTSD and co-occurring problems, dissemination challenges, and analyzing the cost-effectiveness of treatments. Prior edition editors: Edna B. Foa, Terence M. Keane, Matthew J. Friedman, and Judith A. Cohen.
New to This Edition
- Fully rewritten to reflect over a decade of clinical, empirical, and theoretical developments, as well as changes in DSM-5 and ICD-11.
- Increased research-to-practice focus—helps the clinician apply the recommendations in specific clinical situations.
- New chapters on previously covered treatments: early interventions, psychopharmacotherapy for adults and children, and EMDR therapy.
- Chapters on additional treatments: prolonged exposure, cognitive processing therapy, cognitive therapy, combined psychotherapy and medication, e-mental health, and complementary and alternative approaches.
- Chapters on cutting-edge topics, including personalized interventions and advances in implementation science.
“When I received the review copy of this book, I immediately pressed it into service....The authors and editors of this book are to be commended for the neat package of materials they have assembled that provides information that both researchers and clinicians need in an unbiased yet easy-to-access style. I believe this book will be important for anyone interested in the current state of the art in trauma treatment or who wants to know what is happening in trauma research. I highly recommend this book for both scientists and practitioners.”
—PsycCRITIQUES (on the second edition)
“The third edition builds on the extraordinary contributions of the two prior editions. The well-chosen authors have integrated standardized, rigorous reviews of the latest research with extremely helpful guidelines on how to apply the research recommendations in clinical practice settings. The book incorporates a number of significant advances and new topics and highlights future directions for the field in a thoughtful and practical way. This is a scientifically grounded, visionary book that is an essential resource for clinicians, researchers, and advanced graduate students.”
—Patricia J. Watson, PhD, Senior Educational Specialist, National Center for PTSD
“This impressive book thoroughly summarizes the state of the art in evidence-based approaches to early intervention and treatment for PTSD. It is unique in accomplishing something that previous (often technical and dry) consensus best-practice guidelines have not—it fleshes out research findings in a way that enables clinicians to make informed choices about how to best help trauma survivors in particular contexts. Chapters provide rich details about clinical procedures and discuss who is most likely to benefit, how to avoid pitfalls and maximize impact, and what to do about problems that arise. The editors and contributors are experts with tremendous training and clinical experience.”
—Brett T. Litz, PhD, Director, Mental Health Core, Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine
“The third edition of this book takes an important step in bridging the gap between evidence-based guidelines and clinical practice. Clinicians face an array of barriers attempting to integrate findings from randomized clinical trials into their day-to-day work. The book is genuinely unique and much needed—each chapter goes beyond the research evidence to explore the challenges of applied implementation, providing practical and effective treatment recommendations. If you are working with those struggling with PTSD, this is a 'must read' regardless of clinical setting. You simply won’t find more innovative, comprehensive coverage of this critical topic.”
—M. David Rudd, PhD, ABPP, President and Distinguished University Professor of Psychology, University of Memphis
“Congratulations to Dave Forbes, Jon Bisson, Candice Monson, and Lucy Berliner on overseeing this new edition. They have masterfully synthesized the wide-ranging research on treating PTSD that has been going on since the second edition of this volume came out. Their editorial vision has brought a fresh perspective to the ISTSS treatment guidelines, and offers the field an invaluable resource. We’re thrilled to see the careful work in this arena continue, giving guidance to practitioners and researchers around the world.”
—Edna B. Foa, PhD; Terence M. Keane, PhD; Matthew J. Friedman, MD, PhD; and Judith A. Cohen, MD, editors of Effective Treatments for PTSD, Second Edition
Table of Contents
I. Introduction and Background
1. Effective Treatments for PTSD: Guiding Current Practice and Future Innovation, David Forbes, Jonathan I. Bisson, Candice M. Monson, & Lucy Berliner
2. Trauma and PTSD: Epidemiology, Comorbidity, and Clinical Presentation in Adults, Kristina J. Korte, Tammy Jiang, Karestan C. Koenen, & Jaimie Gradus
3. Epidemiology, Clinical Presentation, and Developmental Considerations in Children and Adolescents, Eva Alisic, Rowena Conroy, & Siri Thoresen
4. Diagnosis, Assessment, and Screening for PTSD and Complex PTSD in Adults, Jonathan I. Bisson, Chris R. Brewin, Marylene Cloitre, & Andreas Maercker
5. Screening, Assessment, and Diagnosis in Children and Adolescents, Lucy Berliner, Richard Meiser-Stedman, & Andrea Danese
6. ISTSS PTSD Prevention and Treatment Guidelines: Methodology, Jonathan I. Bisson, Catrin Lewis, & Neil Roberts
7. ISTSS PTSD Prevention and Treatment Guidelines: Recommendations, Jonathan I. Bisson, Lucy Berliner, Marylene Cloitre, David Forbes, Tine Jensen, Catrin Lewis, Candice M. Monson, Miranda Olff, Stephen Pilling, David Riggs, Neil Roberts, & Francine Shapiro
II. Early Intervention in Adults
8. Early Intervention for Trauma-Related Psychopathology, Meaghan L. O’Donnell, Belinda J. Pacella, Richard A. Bryant, Miranda Olff, & David Forbes
9. Early Pharmacological Intervention Following Exposure to Traumatic Events, Jonathan I. Bisson, Laurence Astill Wright, & Marit Sijbrandij
III. Early Intervention in Children and Adolescents
10. Preventative and Early Interventions, Justin Kenardy, Nancy Kassam-Adams, & Grete Dyb
IV. Treatments for Adults
11. Psychological Treatments: Core and Common Elements of Effectiveness, Miranda Olff, Candice M. Monson, David Riggs, Christopher W. Lee, Anke Ehlers, & David Forbes
12. Prolonged Exposure, David S. Riggs, Larissa Tate, Kelly Chrestman, & Edna B. Foa
13. Cognitive Processing Therapy, Kathleen M. Chard, Debra L. Kaysen, Tara E. Galovski, Reginald D. V. Nixon, & Candice M. Monson
14. Eye Movement Desensitization and Reprocessing Therapy, Francine Shapiro, Mark C. Russell, Christopher W. Lee, & Sarah J. Schubert
15. Cognitive Therapy, Anke Ehlers
16. Pharmacological and Other Biological Treatments, Jonathan I. Bisson, Mathew Hoskins, & Dan J. Stein
17. Combined Psychotherapy and Medication Treatment, Mark Burton, Jessica Maples-Keller, Mathew Hoskins, Yilang Tang, Katarzyna Wyka, JoAnn Difede, & Barbara O. Rothbaum
18. E-Mental Health, Catrin Lewis & Miranda Olff
19. Complementary, Alternative, and Integrative Interventions, Ariel Lang & Barbara Niles
20. Treatment of Complex PTSD, Marylene Cloitre, Thanos Karatzias, & Julian Ford
V. Treatments for Children and Adolescents
21. Treatment of PTSD and Complex PTSD, Tine Jensen, Judy Cohen, Lisa Jaycox, & Rita Rosner
VI. Application, Implementation, and Future Directions
22. Treatment Considerations for PTSD Comorbidities, Neil P. Roberts, Sudie E. Back, Kim Mueser, & Laura K. Murray
23. Building a Science of Personalized Interventions for PTSD, Marylene Cloitre, Zachary Cohen, & Ulrich Schnyder
24. Training and Implementation of Evidence-Based Psychotherapies for PTSD, David S. Riggs, Maegan M. Paxton, Sybil Mallonee, Craig Rosen, Shannon Wiltsey Stirman, & Shannon Dorsey
25. A Health Economics View, Ifigeneia Mavranezouli & Cathy Mihalopoulos
26. The Future of Traumatic Stress Treatments: Time to Grasp the Opportunity, David Forbes, Jonathan I. Bisson, Candice M. Monson, & Lucy Berliner
About the Editors
David Forbes, PhD, is Director of Phoenix Australia Centre for Posttraumatic Mental Health and Professor in the Department of Psychiatry at the University of Melbourne. He began practicing as a clinical psychologist in the mid-1990s and has a strong research track record in the assessment and treatment of mental health problems in trauma survivors, with a specialty in military, veteran, emergency services, and post-disaster mental health. Dr. Forbes led the development of the Australian Guidelines for the Treatment of
Acute Stress Disorder and PTSD and is Co-Chair of the 5-Eyes Mental Health Research and Innovation Collaboration.
Jonathan I. Bisson, DM, FRCPsych, is Professor of Psychiatry at Cardiff University School of Medicine, Wales, United Kingdom, and a practicing psychiatrist. He is Chair of the Treatment Guidelines Committee of the International Society for Traumatic Stress Studies and is currently developing an All Wales Traumatic Stress Quality Improvement Initiative. Dr. Bisson was Co-Chair of the first PTSD Guideline Development Group of the United Kingdom's National Institute for Health and Care Excellence. He is a past president of the European Society for Traumatic Stress Studies, and led the development of Veterans NHS Wales. He has conducted widely cited research on the prevention and treatment of PTSD.
Candice M. Monson, PhD, is Professor of Psychology at Toronto Metropolitan University in Toronto, Ontario, Canada. A Fellow of the American and Canadian Psychological Associations and the Royal Society of Canada, she is a recipient of the Traumatic Stress Psychologist of the Year Award from the Canadian Psychological Association and the Distinguished Mentorship Award from the International Society for Traumatic Stress Studies. Dr. Monson is well known for her research on interpersonal factors in traumatization and the development, testing, and dissemination of treatments for posttraumatic stress disorder (PTSD), including cognitive processing therapy and cognitive-behavioral conjoint therapy for PTSD.
Lucy Berliner, MSW, is Director of the Harborview Center for Sexual Assault and Traumatic Stress at the University of Washington, where she is also Clinical Associate Professor in the School of Social Work and in the Department of Psychiatry and Behavioral Sciences. Her activities include clinical practice with child and adult victims of trauma and crime; research on the impact of trauma and the effectiveness of clinical and societal interventions; and participation in local and national social policy initiatives to promote the interests of trauma and crime victims.
Contributors
Eva Alisic, PhD, Child and Community Wellbeing Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia
Sudie E. Back, PhD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
Lucy Berliner, MSW, Harborview Abuse and Trauma Center, Seattle, Washington
Jonathan I. Bisson, DM, FRCPsych, Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
Chris R. Brewin, PhD, Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
Richard A. Bryant, PhD, School of Psychology, University of New South Wales, Sydney, Australia
Mark Burton, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
Kathleen M. Chard, PhD, Trauma Recovery Center, Cincinnati VA Medical Center and Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
Kelly Chrestman, PhD, Center for Deployment Psychology, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Marylene Cloitre, PhD, National Center for PTSD, Palo Alto VA Health Care Services, Palo Alto, California; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
Judith Cohen, MD, Department of Psychiatry, Drexel University College of Medicine, Pittsburgh, Pennsylvania
Zachary Cohen, PhD, National Center for PTSD, Palo Alto, California; Department of Psychiatry, University of California, Los Angeles, Los Angeles, California
Rowena Conroy, PhD, School of Psychological Sciences, University of Melbourne, Melbourne, Australia
Andrea Danese, MD, PhD, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
JoAnn Difede, PhD, Department of Psychology, Weill Cornell Medicine, New York, New York
Shannon Dorsey, PhD, Department of Psychology, University of Washington, Seattle, Washington
Grete Dyb, MD, PhD, Norwegian Centre for Violence and Traumatic Stress Studies and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Anke Ehlers, PhD, Oxford Centre for Anxiety Disorders and Trauma, Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
Edna B. Foa, PhD, Center for the Study and Treatment of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
David Forbes, PhD, Phoenix Australia Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Melbourne, Australia
Julian D. Ford, PhD, ABPP, Center for Trauma Recovery and Juvenile Justice, Center for the Treatment of Developmental Trauma Disorders, and Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut
Tara E. Galovski, PhD, National Center for PTSD, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
Jaimie Gradus, DSc, MPH, Department of Epidemiology, Boston University School of Public Health; and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
Mathew D. Hoskins, MBBCh, MSc, MRCPsych, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
Lisa Jaycox, PhD, RAND Corporation, Arlington, Virginia
Tine Jensen, PhD, Department of Psychology, University of Oslo, and Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
Tammy Jiang, MPH, Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
Thanos Karatzias, PhD, School of Health and Social Care, Edinburgh Napier University, and NHS Lothian Rivers Centre for Traumatic Stress, Edinburgh, United Kingdom
Nancy Kassam-Adams, PhD, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
Debra L. Kaysen, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Palo Alto, California
Justin Kenardy, PhD, School of Psychology, University of Queensland, Queensland, Australia
Karestan C. Koenen, PhD, Departments of Epidemiology and Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts
Kristina J. Korte, PhD, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
Ariel J. Lang, PhD, MPH, VA San Diego Center for Excellence for Stress and Mental Health and Departments of Psychiatry and Family Medicine and Public Health, University of California, San Diego, San Diego, California
Christopher Lee, PhD, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
Catrin Lewis, PhD, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
Andreas Maercker, MD, PhD, Department of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
Sybil Mallonee, PhD, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Jessica Maples-Keller, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
Ifigeneia Mavranezouli, MD, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
Richard Meiser-Stedman, PhD, Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, United Kingdom
Cathrine Mihalopoulos, PhD, School of Health and Social Development, Deakin University, Geelong, Australia
Candice M. Monson, PhD, Department of Psychology, Ryerson University, Toronto, Ontario, Canada
Kim T. Mueser, PhD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts
Laura K. Murray, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Barbara Niles, PhD, National Center for PTSD, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
Reginald D. V. Nixon, PhD, College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
Meaghan L. O’Donnell, PhD, Phoenix Australia Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Melbourne, Australia
Miranda Olff, PhD, Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands; ARQ National Psychotrauma Centre, Diemen, Netherlands
Belinda J. Pacella, MClinPsych, Phoenix Australia Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Melbourne, Australia
Stephen Pilling, PhD, Division of Psychology and Language Sciences, University College London, London, United Kingdom
David S. Riggs, PhD, Center for Deployment Psychology, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Neil P. Roberts, DClinPsy, Cardiff and Vale University Health Board and Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
Craig Rosen, PhD, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California
Rita Rosner, DPhil, DiplPsych, Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
Barbara O. Rothbaum, PhD, ABPP, Emory Healthcare Veterans Program and Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
Mark C. Russell, PhD, School of Applied Psychology, Counseling and Family Therapy, Antioch University, Seattle, Washington
Ulrich Schnyder, MD, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital, University of Zurich, Zurich, Switzerland
Sarah J. Schubert, PhD, private practice, Brentwood, Australia
Francine Shapiro, PhD (deceased), Mental Research Institute, Palo Alto, California; EMDR Institute, Watsonville, California
Marit Sijbrandij, PhD, Department of Clinical, Neuro, and Developmental Psychology and WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University Amsterdam, Amsterdam, Netherlands
Dan J. Stein, FRCPC, PhD, SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
Shannon Wiltsey Stirman, PhD, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California; Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California
Yilang Tang, MD, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, and Atlanta VA Medical Center, Atlanta, Georgia
Larissa Tate, MS, MPS, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Siri Thoresen, PhD, Norwegian Centre for Violence and Traumatic Stress Studies and Department of Psychology, University of Oslo, Oslo, Norway
Maegan M. Paxton Willing, BS, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Laurence Astill Wright, MBBCH, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom
Katarzyna Wyka, PhD, Department of Psychiatry, Weill Cornell Medicine, New York, New York
Audience
Clinical psychologists, psychiatrists, clinical social workers, counselors, and psychiatric nurses; graduate students and residents.
Course Use
Serves as a text in graduate-level courses on trauma and PTSD.
Previous editions published by Guilford:
Second Edition, © 2009
ISBN: 9781609181499
First Edition, © 2000
ISBN: 9781593850142
New to this edition:
- Fully rewritten to reflect over a decade of clinical, empirical, and theoretical developments, as well as changes in DSM-5 and ICD-11.
- Increased research-to-practice focus—helps the clinician apply the recommendations in specific clinical situations.
- New chapters on previously covered treatments: early interventions, psychopharmacotherapy for adults and children, and EMDR therapy.
- Chapters on additional treatments: prolonged exposure, cognitive processing therapy, cognitive therapy, combined psychotherapy and medication, e-mental health, and complementary and alternative approaches.
- Chapters on cutting-edge topics, including personalized interventions and advances in implementation science.