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Posttraumatic Stress Disorder and Cognitive Behavioral Therapy
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To the Editor: In their study of the treatment of women with posttraumatic stress disorder (PTSD), Dr Schnurr and colleagues1 reported the superiority of prolonged exposure over present-centered therapy. We believe that their use of present-centered therapy as a comparison group is problematic.
Present-centered therapy was described as "clinically relevant" and as a "control for the nonspecific benefits of therapy." Present-centered therapy was used so that the effects of prolonged exposure could be attributed to prolonged exposure rather than the purported "benefits of good therapy." Present-centered therapy, however, did not appear to represent a bona fide therapy. The treatment was described as primarily involving discussion and review of "general daily difficulties," specifically prohibiting any exposure or cognitive restructuring. Their methods article discusses present-centered therapy in more detail, stating that if the patient mentions "trauma-related issues, the therapist gently redirects her to discuss other material."2
It is difficult to understand how . . . [Full Text of this Article]
Glen I. Spielmans, PhD
glen.spielmans@metrostate.edu
Éowyn T. Gatlin
Metropolitan State University
St Paul, Minn
RELATED LETTER
Posttraumatic Stress Disorder and Cognitive Behavioral Therapy—Reply
Paula P. Schnurr, M. Tracie Shea, Matthew J. Friedman, and Charles C. Engel
JAMA. 2007;297(24):2695.
EXTRACT
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RELATED ARTICLE
Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Women: A Randomized Controlled Trial
Paula P. Schnurr, Matthew J. Friedman, Charles C. Engel, Edna B. Foa, M. Tracie Shea, Bruce K. Chow, Patricia A. Resick, Veronica Thurston, Susan M. Orsillo, Rodney Haug, Carole Turner, and Nancy Bernardy
JAMA. 2007;297(8):820-830.
ABSTRACT
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