Treating Trauma Survivors With PTSD.

OVERVIEW

In recent years, considerable research, as well as clinical guidelines based on study findings, has been published on the treatment of posttraumatic stress disorder (PTSD). A gap remains, however, between the controlled environments and protocols used in intervention research and the more complex and often imperfect settings and situations that clinicians must navigate in daily practice. Moreover, clinicians routinely see patients whose comorbid substance abuse, self-destructive behavior, or medical illness would likely exclude them from research studies. In short, although the extensive literature is certainly helpful in articulating the various treatment modalities available to clinicians, the strength of the evidence for the efficacy of the treatments, and the recommendations and personal preferences of experts, the literature does not address the real-life dilemmas that clinicians face in attempting to treat trauma survivors.

What is needed is a way to bridge the gap between research and practice—to “translate” study findings into everyday clinical realities. Treating Trauma Survivors With PTSD answers that need. Its authors, experienced researchers and clinicians who are at the forefront of conceptual discourse on trauma and PTSD, are uniquely qualified to offer guidance on these issues. Among the specific topics covered are the following:

• Diagnosis and assessment of and treatment planning for trauma survivors with PTSD, including clinical presentations related to trauma exposure and PTSD and the implications of comorbid symptoms and disorders
• Treatment matching in clinical practice—how treatment outcome findings can be used to develop profiles for predicting which patients are most likely to respond to which treatments
• Medications useful in the treatment of PTSD and the strength of the empirical evidence for their efficacy
• Trauma in children and the efficacy of various treatments, including a discussion of how treatment for children differs from that for adults
• Assessment and treatment of multiply traumatized patients—those with both recent trauma and a history of childhood trauma or abuse
• Treatment of trauma survivors in the acute aftermath of traumatic events, including a review of some of the exciting developments in the field regarding risk factors (e.g., normal vs. pathological coping responses) that influence which individuals are most likely to develop PTSD after such events.

These topics have never been more relevant than now, in the wake of the attacks that shook our country on September 11, 2001. It is the authors’ hope that by reading this book, mental health practitioners will gain more confidence in applying the specialized techniques described in empirical studies to their own practices and clinical realities.

TABLE OF CONTENTS

Introduction: bridging the gap between intervention research and practice.

Treatment planning for trauma survivors with PTSD: what does a clinician need to know before implementing PTSD treatments?

Diagnosis, assessment, and monitoring outcomes in PTSD.

Specialized treatment for PTSD: matching survivors to the appropriate modality.

Rational and role for medication in the comprehensive treatment of PTSD.

Treatment of traumatized children.

Assessment and treatment of complex PTSD.

Treating survivors in the immediate aftermath of traumatic events. Index.

REVIEWS

“The book offers a snapshot of a relatively young field of psychiatric research, revealing important advances and the gaps that remain in our knowledge. . . . The treatment of trauma survivors is a complex, challenging, and often politicized topic. Although more empirical evidence is needed to guide treatment decisions, clinicians will have to continue treating trauma survivors even in the absence of badly needed studies. Thus a dialogue between the researchers and the clinicians will help make treatment decisions as informed as possible and will help make the research more clinically relevant. The goal of this book, as stated in the introduction, is to initiate such a dialogue, and the authors have done their part. Now, it is the reader's turn.”
—Israel Liberzon, M.D., New England Journal of Medicine, February 2003

“This is an excellent contribution to the material on PTSD. The content is directed to diagnosis and treatment, making it very practical. The busy clinician already versed in treating PTSD through experience will appreciate the clear and critical presentation of research on the topic. Five Stars!”
—Doody’s Health Science Book Review Journal, August 2002

“This is a scholarly text for practitioners. With comprehensive review of the scientific literature as a backdrop, this book tackles the common complex treatment decisions that challenge clinicians everyday. How to combine PTSD treatments when all published clinical trials have only tested one treatment at a time? When to discontinue or augment treatment? How to treat PTSD that is comorbid with another psychiatric disorder? And how to treat posttraumatic syndromes that do not conform to PTSD diagnostic criteria? A major strength of this volume is that its wealth of information is embedded in a theoretical context that equips practitioners with conceptual as well as clinical tools.”
—Matthew J. Friedman, M.D., Ph.D., Executive Director, National Center for PTSD; Professor of Psychiatry and Pharmacology, Dartmouth Medical School, Hanover, New Hampshire

ABOUT THE AUTHOR

Rachel Yehuda, Ph.D., is Director of the Division of Traumatic Stress Studies Program and Professor in the Department of Psychiatry at Mount Sinai School of Medicine and the PTSD Program at the VA Medical Center in Bronx, New York.