Cognitive Behavioral Treatment for PTSD

Part of the Springer Series on Stress and Coping book series (SSSO)


Cognitive behavioral therapies encompass a range of procedures, a number of which have been found efficacious in treating PTSD. These include variations of exposure, cognitive restructuring, and anxiety management training, as well as combinations of methods. In this chapter, we review the cognitive behavioral treatments that have been studied in PTSD populations and describe the theories underlying the treatments and the research literature examining their efficacy.


Ptsd Symptom Posttraumatic Stress Disorder Cognitive Behavioral Treatment Cognitive Restructuring Exposure Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Beck, A. T. (1972). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.Google Scholar
  2. Beck, A. T., Emery, G.,& Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.Google Scholar
  3. Beck, A. T., Rush, A. J., Shaw, B. F.,& Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.Google Scholar
  4. Blanchard, E. B.,& Abel, G. G. (1976). An experimental case study of the biofeedback treatment of a rape induced psychophysiological cardiovascular disorder. Behavior Therapy, 7, 113–119.CrossRefGoogle Scholar
  5. Boudewyns, P. A.,& Hyer, L. (1990). Physiological response to combat memories and preliminary treatment outcome in Vietnam veteran PTSD patients treated with direct therapeutic exposure. Behavior Therapy, 21, 63–87.CrossRefGoogle Scholar
  6. Boudewyns, P. A., Hyer, L., Woods, M. G., Harrison, W. R.,& McCranie, E. (1990). PTSD among Vietnam veterans: An early look at treatment outcome using direct therapeutic exposure. Journal of Traumatic Stress, 3, 359–368.CrossRefGoogle Scholar
  7. Brom, D., Kleber, R. J.,& Defares, P. B. (1989). Brief psychotherapy for posttraumatic stress disorders. Journal of Consulting and Clinical Psychology, 51, 607–612.CrossRefGoogle Scholar
  8. Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470.PubMedCrossRefGoogle Scholar
  9. Cooper, N. A.,& Clum, G. A. (1989). Imaginai flooding as a supplementary treatment for PTSD in combat veterans: A controlled study. Behavior Therapy, 20, 381–391.CrossRefGoogle Scholar
  10. Echeburua, E., de Corral, P., Sarasua, B.,& Zubizarreta, I. (1996). Treatment of acute posttraumatic stress disorder in rape victims: An experimental study. Journal of Anxiety Disorders, 10, 185–199.CrossRefGoogle Scholar
  11. Echeburua, E., de Corral, P. Zubizarreta, I.,& Sarasua, B. (1997). Psychological treatment of chronic posttraumatic stress disorder in victims of sexual aggression. Behavior Modification, 21, 433–456.PubMedCrossRefGoogle Scholar
  12. Epstein, R. S. (1989). Posttraumatic stress disorder: A review of diagnostic and treatment issues. Psychiatric Annals, 19, 556–563.Google Scholar
  13. Fairbank, J. A.,& Keane, T. M. (1982). Flooding for combat-related stress disorders: Assessment of anxiety reduction across traumatic memories. Behavior Therapy, 13, 499–510.CrossRefGoogle Scholar
  14. Foa, E. B.,& Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35.PubMedCrossRefGoogle Scholar
  15. Foa, E. B.,& Meadows, E. A. (1997). The psychosocial treatment of PTSD: A critical review. Annual Review of Psychology, 48, 449–480.PubMedCrossRefGoogle Scholar
  16. Foa, E. B.,& Rothbaum, B. O. (1998). Treating the trauma of rape New York: Guilford.Google Scholar
  17. Foa, E. B., Dancu, C. V, Hembree, E., Jaycox, L. H., Meadows, E. A.,& Street, G. (1999). A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67, 194–200.PubMedCrossRefGoogle Scholar
  18. Foa, E. B., Rothbaum, B. O.,& Kozak, M.J. (1989). Behavioral treatments of anxiety and depression. In P. Kendall& D. Watson (Eds.), Anxiety and depression: Distinctive and overlapping features (pp. 413–454). New York: Academic Press.Google Scholar
  19. Foa, E. B., Rothbaum, B. O., Riggs, D. S.,& Murdock, T. B. (1991). Treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive-behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715–723.PubMedCrossRefGoogle Scholar
  20. Frank, E.,& Stewart, B. D. (1983). Physical aggression: Treating the victims. In E. A. Bleckman (Ed.), Behavior modification with women (pp. 245–272). New York: Guilford.Google Scholar
  21. Frank, E.,& Stewart, B. D. (1984). Depressive symptoms in rape victims, Journal of Affective Disorders, 1, 269–277.CrossRefGoogle Scholar
  22. Frank, E., Anderson, B., Stewart, B. D., Dancu, C, Hughes, C,& West, D. (1988). Efficacy of cognitive behavior therapy and systematic desensitization in the treatment of rape trauma. Behavior Therapy, 19, 403–420.CrossRefGoogle Scholar
  23. Frueh, B. C, Turner, S. M., Beidel, D. C, Mirabella, R. F., & Jones, W.J. (1996). Trauma Management Therapy: A preliminary evaluation of a multicomponent behavioral treatment for chronic combat-related PTSD. Behaviour Research and Therapy, 34, 533–543.PubMedCrossRefGoogle Scholar
  24. Hickling, E. J.,& Blanchard, E. B. (1997). The private practice psychologist and manual-based treatments: Post-traumatic stress disorder secondary to motor vehicle accidents. Behaviour Research and Therapy, 35, 191–203.PubMedCrossRefGoogle Scholar
  25. Hickling, E.J., Sison, G. F. P.,& Vanderploeg, R. D. (1986). Treatment of posttraumatic stress disorder with relaxation and biofeedback training. Biofeedback&Self-Regulation, 11, 125–134.CrossRefGoogle Scholar
  26. Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma, New York: The Free Press.Google Scholar
  27. Jaycox, L. H.,& Foa, E. B. (1996). Obstacles in implementing exposure therapy for PTSD: Case discussions and practical solutions. Clinical Psychology and Psychotherapy, 3, 176–184.CrossRefGoogle Scholar
  28. Johnson, C. H., Gilmore, J. D.,& Shenoy, R. Z. (1982). Use of a feeding procedure in the treatment of a stress-related anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 13, 235–237.PubMedCrossRefGoogle Scholar
  29. Keane, T. M.,& Kaloupek, D. G. (1982). Imaginai flooding in the treatment of post-traumatic stress disorder. Journal of Consulting and Clinical Psychology, 50, 138–140.PubMedCrossRefGoogle Scholar
  30. Keane, T. M., Fairbank, J. A., Caddell, J. M.,& Zimering, R. T. (1989). Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans. Behavior Therapy, 20, 245–260.CrossRefGoogle Scholar
  31. Kilpatrick, D. G.,& Amick, A. E. (1985). Rape trauma. In M. Hersen& C. G. Last (Eds.), Behavior therapy casebook. New York: Springer.Google Scholar
  32. Kilpatrick, D. G., Veronen, L. J.,& Resick, P. A. (1982). Psychological sequelae to rape: Assessment and treatment strategies. In D. M. Doleys, R. L. Meredith,& A. R. Ciminero (Eds.), Behavioral medicine: Assessment and treatment strategies (pp. 473–497). New York: Plenum.Google Scholar
  33. Marks, I., Lovell, K., Noshirvani, H., Livanou, M.,& Thrasher, S. (1998). Treatment of post-traumatic stress disorder by exposure and/or cognitive restructuring: A controlled study. Archives of General Psychiatry, 55, 317–325.PubMedCrossRefGoogle Scholar
  34. McCann, I. L.,& Pearlman, L. A. (1990). Psychological trauma and the adult survivor: Theory, therapy, and transformation. New York: Brunner/Mazel.Google Scholar
  35. McCann, I. L., Sakheim, D. K.,& Abrahamson, D. J. (1988). Trauma and victimization: A model of psychological adaptation. The Counseling Psychologist, 16, 531–594.CrossRefGoogle Scholar
  36. Meichenbaum, D. (1974). Self-instructional methods. In F. H. Kanfer& A. P. Goldstein (Eds.), Helping people change. New York: Pergamon.Google Scholar
  37. Mowrer, O. A. (1960). Learning theory and behavior. New York: John Wiley&Sons.CrossRefGoogle Scholar
  38. Pearson, M. A., Poquette, B. M.,& Wasen, R. E. (1983). Stress inoculation and the treatment of post-rape trauma: A case report. The Behavior Therapist, 6, 58–59.Google Scholar
  39. Peniston, E. G. (1986). EMG biofeedback-assisted desensitization treatment for Vietnam combat veterans’ post-traumatic stress disorder. Clinical Biofeedback Health, 9, 35–41.Google Scholar
  40. Pitman, R. K., Orr, S. P., Altman, B., Longpre, R. E., Poire, R. E.,& Macklin, M. L. (1996). Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder. Comprehensive Psychiatry, 37, 419–429.PubMedCrossRefGoogle Scholar
  41. Resick, P. A.,& Schnicke, M. K. (1992a). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60, 748–756.PubMedCrossRefGoogle Scholar
  42. Resick, P. A.,& Schnicke, M. K. (1992b). Cognitive processing therapy for sexual assault victims. In E. G. Foa (Chair), Treatment of PTSD: An update. Presented at the Eighth Annual Meeting of the International Society for Traumatic Stress Studies, Los Angeles, CA.Google Scholar
  43. Resick, P. A. Jordan, C. G., Girelli, S. A., Hutter, C. K.,& Marhoefer-Dvorak, S. (1988). A comparative outcome study of group behavioral therapy for sexual assault victims. Behavior Therapy, 19, 385–401.CrossRefGoogle Scholar
  44. Resick, P. A., Nishith, P.,&Astin, M. (1998, March). A controlled trial comparing cognitive processing therapy and prolonged exposure: Preliminary findings Paper presented at the Lake George Research Conference on Posttraumatic Stress Disorder, Lake George, NY.Google Scholar
  45. Richards, D. A., Lovell, K.,& Marks, I. M. (1994). Post-traumatic stress disorder: Evaluation of a behavioral treatment program. Journal of Traumatic Stress, 7, 669–680.PubMedCrossRefGoogle Scholar
  46. Rothbaum, B. O. (1997). A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims. Bulletin of the Menninger Clinic, 6, 317–334.Google Scholar
  47. Rothbaum, B. O., Foa, E. B., Murdock, T., Riggs, D.,& Walsh, W. (1992). A prospective examination of posttraumatic stress disorder in rape victims. Journal of Traumatic Stress, 5, 455–475.CrossRefGoogle Scholar
  48. Schindler, F. E. (1980). Treatment by systematic desensitization of a recurring nightmare of a real life trauma. Journal of Behavior Therapy and Experimental Psychiatry, 11, 53–54.CrossRefGoogle Scholar
  49. Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. New York: Guilford.Google Scholar
  50. Silver, S. M, Brooks, A.,& Obenchain, J. (1995). Treatment of Vietnam war veterans with PTSD: A comparison of eye movement desensitization and reprocessing, biofeedback, and relaxation training. Journal of Traumatic Stress, 8, 337–342.PubMedCrossRefGoogle Scholar
  51. Stampfl, T. G.,& Levis, D.J. (1967). Essentials of implosive therapy: A learning-theory-based psychodynamic behavioral therapy. Journal of Abnormal Psychology, 72, 496–503.PubMedCrossRefGoogle Scholar
  52. Suinn, R. (1974). Anxiety management training for general anxiety. In R. Suinn& R. Weigel (Eds.), The innovative therapy: Critical and creative contributions. New York: Harper&Row.Google Scholar
  53. Thompson, J. A., Charlton, P. F. C, Kerry, R., Lee, D.,& Turner, S. W. (1995). An open trial of exposure therapy based on deconditioning for post-traumatic stress disorder. British Journal of Clinical Psychiatry, 34, 407–416.CrossRefGoogle Scholar
  54. Tolin, D. F., Montgomery, R. W., Kleinknecht, R. A.,& Lohr. J. M. (1996). An evaluation of eye movement desensitization and reprocessing (EMDR). In T. Jackson (Ed.), Innovations in clinical practice, Vol. 15. Sarasota, FL: Professional Resources Press.Google Scholar
  55. Turner, S. M. (1979). Systematic desensitization of fears and anxiety in rape victims. Presented at the Annual Meeting of the Association for Advancement of Behavior Therapy, San Francisco, CA.Google Scholar
  56. Vaughan, K., Armstrong, M. S., Gold, R., O’Connor, N., Jenneke, W.,& Tarrier, N. (1994). A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 25(4), 283–291.PubMedCrossRefGoogle Scholar
  57. Veronen, L. J.,& Kilpatrick, D. G. (1981). Stress inoculation training for victims of rape: Efficacy and differential findings. Presented at the 16th Annual Convention of the Association for Advancement of Behavior Therapy, Los Angeles, CA.Google Scholar
  58. Watts, F. N. (1979). Habituation model of systematic desensitization. Psychological Bulletin, 86, 627–637.PubMedCrossRefGoogle Scholar
  59. Wolff, R. (1977). Systematic desensitization and negative practice to alter the after effects of a rape attempt. Journal of Behavior Therapy and Experimental Psychiatry, 8, 423–425.CrossRefGoogle Scholar
  60. Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford: Stanford University Press.Google Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  1. 1.Department of PsychologyCentral Michigan UniversityMt. PleasantUSA
  2. 2.Center for the Treatment and Study of AnxietyUniversity of Pennsylvania Health SystemPhiladelphiaUSA

Personalised recommendations