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Intensive Cognitive-Behavioral Treatment of PTSD: An Overview of Massed Outpatient Treatment Programs

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Comprehensive Guide to Post-Traumatic Stress Disorder

Abstract

Cognitive-behavioral treatment usually lasts several months with sessions being delivered on a weekly basis. However, despite its status as highly effective first-line treatment for PTSD, given the relatively low remission, high dropout, and low accessibility of cognitive-behavioral treatment, there is room for improvement. Empirical work suggests that optimizing cognitive-behavioral treatment dose might enhance PTSD treatment outcome. This has sparked different groups to explore the efficacy of intensified programs for adults where the treatment sessions are massed. In this chapter, the literature on outpatient PTSD programs delivered in such an intensive format is reviewed to investigate whether the findings support the anticipated benefits while considering potential risks. The reviewed studies showed that PTSD symptoms can indeed be substantially reduced (medium to large effect sizes) in a relatively short period (within one to three weeks). Although treatment response was not superior to that of programs offering weekly sessions, symptom reduction occurred faster while the results also suggest that massed intensive cognitive-behavioral treatment may prevent patients from dropping out. There are no reports of symptom exacerbation or adverse events indicating that the treatments are safe and well tolerated. While not improving treatment response as such, the fast response and low dropout suggest that massed cognitive-behavioral treatment is making trauma-focused treatment more accessible. Future research is needed that compares the effectiveness and long-term effects of weekly based versus intensive cognitive-behavioral treatment for PTSD in controlled studies.

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Abbreviations

BAI:

Beck Anxiety Inventory

BDI/BDI-II:

Beck Depression Inventory/second edition

CAPS:

Clinician-Administered PTSD Scale

CBM:

Cognitive Bias Modification

CBT:

Cognitive-Behavioral Therapy

CT:

Cognitive Therapy

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders 4th edition

EFST:

Emotion-Focused Supportive Treatment

EMDR:

Eye Movement Desensitization and Reprocessing

IES:

Impact of Events Scale

NICE:

National Institute for Health and Clinical Excellence

OCD:

Obsessive-Compulsive Disorder

PCL:

PTSD Checklist – Military version

PCL-S:

PTSD Checklist-Stressor-specific

PDS:

Posttraumatic Diagnostic Scale

PSS-I:

PTSD Symptom-Scale Interview

PSS-SR:

PTSD Symptom-Scale Self-report

PsychINFO:

A journal coverage list

PTSD:

Posttraumatic Stress Disorder

PubMed:

The US National Library of Medicine

RCT:

Randomized Controlled Trial

SCL-45:

Symptom Check-List-45

SDS:

Sheehan Disability Scale

WL:

Waiting List

Zung SDS:

Zung Self-Rating Depression Scale

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Authors and Affiliations

  1. Centre for Anxiety Disorders “Overwaal”, Pro Persona, Tarweweg 2, Nijmegen, 6534 AM, The Netherlands

    Lotte Hendriks, Rianne de Kleine, Gert-Jan Hendriks & Agnes van Minnen

  2. Behavioural Science Institute, NijCare, Radboud University, Nijmegen, The Netherlands

    Lotte Hendriks, Rianne de Kleine, Gert-Jan Hendriks & Agnes van Minnen

Authors
  1. Lotte Hendriks
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  2. Rianne de Kleine
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  3. Gert-Jan Hendriks
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  4. Agnes van Minnen
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Corresponding author

Correspondence to Lotte Hendriks .

Editor information

Editors and Affiliations

  1. Buckinghamshire New University, Uxbridge, Middlesex, United Kingdom

    Colin R. Martin

  2. Kings College, London, United Kingdom

    Victor R. Preedy

  3. University of Westminster, London, United Kingdom

    Vinood B. Patel

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Hendriks, L., de Kleine, R., Hendriks, GJ., van Minnen, A. (2015). Intensive Cognitive-Behavioral Treatment of PTSD: An Overview of Massed Outpatient Treatment Programs. In: Martin, C., Preedy, V., Patel, V. (eds) Comprehensive Guide to Post-Traumatic Stress Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-08613-2_123-1

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  • DOI: https://doi.org/10.1007/978-3-319-08613-2_123-1

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  • Online ISBN: 978-3-319-08613-2

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