Talk Therapy for PTSD
Different types of talk therapy (psychotherapy) have been shown to be effective for treating PTSD. Trauma-focused talk therapies are the most highly recommended type of treatment for PTSD. This means that the treatment focuses on the memory of the traumatic event and its meaning.
The trauma-focused therapies include:
There are other types of trauma-focused therapies that are also recommended for people with PTSD. These include: Brief eclectic psychotherapy (BEP), narrative exposure therapy (NET), written narrative exposure, and specific cognitive behavioral therapies for PTSD. You can learn more on the National Center for PTSD website.
How it works
Trauma-focused therapies use different techniques to help you process your traumatic experience. For example, some involve picturing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. Here are the most recommended talk therapies for PTSD:
Prolonged exposure (PE) works by helping you face your fears. People with PTSD often try to avoid anything that reminds them of the trauma. This can help you feel better in the moment, but not in the long-term. Trying to stay away from these feelings and situations actually keeps you from recovering from PTSD. By talking about the details of your trauma and by tackling safe situations you have been avoiding, you can lessen your PTSD symptoms and get back more control of your life.
Cognitive processing therapy (CPT) works by teaching you to reframe thoughts about the trauma. Traumatic events can change the way you think about yourself and the world. You may believe you are to blame for what happened or that the world is a dangerous place. These kinds of thoughts keep you stuck in your PTSD and cause you to miss out on things you used to enjoy. CPT teaches you a new way to handle these upsetting thoughts. In CPT, you will learn skills that can help you decide whether there are more helpful ways to think about your trauma. You will learn how to examine whether the facts support your thought or do not support your thought. And ultimately, you can decide whether or not it makes sense to take a new viewpoint.
Eye movement desensitization and reprocessing (EMDR) works by helping you process and make sense of your trauma. After a traumatic event, people with PTSD often have trouble making sense of what happened to them. In EMDR, you will pay attention to a back-and-forth movement or sound while you call to mind the upsetting memory. You will do this until shifts occur in the way that you experience that memory and more information from the past is processed.
What to expect
Trauma-focused talk therapies help you process your traumatic experience. Because these treatments use different techniques, what you experience will vary based upon the therapy you choose. In general, your mental healthcare provider will start off by giving you an overview of the treatment. You can learn more about what to expect for each treatment with the PTSD Treatment Decision Aid.
Are they effective?
Yes, trauma-focused talk therapies are the most highly recommended type of treatment for PTSD.
What are the risks?
The risks of talk therapy for PTSD are mild to moderate discomfort when talking, writing, or thinking about trauma-related memories or beliefs. These feelings are usually brief and people tend to feel better as they keep doing treatment. Most people who complete trauma-focused talk therapy find that the benefits outweigh any initial discomfort.
Group or individual session
Most talk therapy for PTSD is done individually, where you meet one-on-one with a healthcare provider for each session. CPT can also be done in a group with one or two mental healthcare providers and about 6-10 other people who also have PTSD.
Will I talk in detail about my trauma?
Some talk therapies include talking in detail about your trauma with your mental healthcare provider who will make sure you take things at your own pace. You may also be asked to write about the details of your trauma. Other types of talk therapy do not ask you to write or talk about details of your trauma. But you will be asked to think about your trauma in your session.
Will I have homework?
Some talk therapies will include homework, such as:
Other talk therapies do not include homework between sessions.
How long does treatment last?
Trauma-focused talk therapy usually includes 60-90 minute weekly sessions and treatment lasts about 3 months. You may start to feel better and notice improvement after a few sessions. Research shows that the benefits of PE, CPT, and EMDR often last long after your last session with your mental healthcare provider.
How available is this in VA?
Moderate. Almost all VA Medical Centers offer PE or CPT in their PTSD programs. Smaller VA facilities that do not offer PE or CPT may be able to use video teleconferencing. This means you will receive talk therapy from a mental healthcare provider at another location. EMDR is more widely available outside VA.
Does VA have an app for that?
Yes, VA does have apps for some of the most effective talk therapies for PTSD. PE Coach and CPT Coach are mobile apps that you can use while doing either PE or CPT with your mental healthcare provider. These apps can help you learn more about the treatment and PTSD symptoms and help you stay organized as you complete treatment. Currently, VA does not have an app for EMDR.
How do I choose the best treatment?
Trying to figure out which PTSD treatment is best for you? For more videos about trauma-focused talk therapies and other treatments that work, get started with the PTSD Treatment Decision Aid.
For more information
PTSD Treatment Decision Aid
PE Coach App
CPT Coach App
National Center for PTSD