The guidelines outlined by the New York State Workers Compensation Board provide general recommendations for the treatment of Post-Traumatic Stress Disorder (PTSD). These directives aim to assist healthcare professionals in determining appropriate strategies for addressing and managing PTSD as part of a comprehensive treatment plan.
Healthcare practitioners specializing in the treatment of PTSD can rely on the guidance from the Workers Compensation Board to make well-informed decisions about the most suitable approaches for supporting individuals affected by PTSD.
It is crucial to emphasize that these recommendations are not intended to replace clinical judgment or professional expertise. The ultimate decision regarding the treatment of Post-Traumatic Stress Disorder should involve collaboration between the patient and their healthcare provider.
Behavioral and Psychological Interventions
For any mental health interventions, it’s crucial to have a thorough assessment and a treatment plan that lays out clear, measurable behavioral goals, timeframes, and specific steps for action. When it comes to psychological interventions, the sweet spot is typically three to six months, with a maximum timeframe of nine to twelve months. Some patients might need a bit more time, and if extended counseling is necessary, the treating practitioner should provide updates every four weeks, detailing the psychological factors at play and projecting a realistic functional prognosis during the treatment.
When dealing specifically with PTSD, cognitive behavioral therapy (CBT) is a commonly used approach. CBT involves various component therapies, such as cognitive therapy and different types of exposure therapy. While mind-body interventions, which aim to relieve stress by using the mind to impact physical functioning and enhance overall health, are often used alongside CBT, they are discussed separately.
Trauma-focused psychotherapy refers to any therapeutic approach that employs cognitive, emotional, or behavioral techniques to help individuals process a traumatic experience. In this type of therapy, the trauma itself takes center stage as a crucial component of the overall therapeutic process.
Cognitive Behavioral Therapy (including Cognitive Processing Therapy, Imagery Rehearsal Training, Brief Eclectic Psychotherapy, Narrative Exposure therapy and EMDR)
Suggested – for addressing the needs of patients dealing with ASD and PTSD. How often/How much/How long – Typically, weekly to twice-weekly sessions lasting 60-100 minutes each, spanning at least six weeks and possibly extending up to three months.
Reasons to Stop – When PTSD symptoms resolve, if there’s non-compliance, a lack of effectiveness, or if there are adverse effects. The support for the effectiveness of Cognitive Behavioral Therapies is well-established.
Exposure Therapy and Prolonged Exposure Therapy
Exposure therapy entails guiding a patient through a series of exercises aimed at confronting and reorganizing traumatic memories. This typically involves two main components: 1) visually confronting the trauma and 2) repeatedly revisiting the traumatic memory. Exposure therapies are frequently integrated into Cognitive Behavioral Therapy (CBT) and can take various forms, including virtual reality exposure, imaginal exposure, narrative exposure, in vivo exposure to a traumatic event, and virtual reality exposure (discussed separately).
One specific type, Prolonged Exposure Therapy (PE), mandates a deliberate and repeated visual confrontation with stimuli related to the trauma. It’s recommended for patients with PTSD. Indications include experiencing PTSD symptoms that necessitate therapeutic intervention. The potential benefits encompass an improvement in PTSD symptoms and a reduction in the emotional response to traumatic stimuli, aiding in the emotional processing of the traumatic experience.
The recommended frequency involves weekly 90-minute sessions over ten weeks, with reassessment every four weeks. This approach has demonstrated documented efficacy in terms of enhancing PTSD symptoms and overall functional improvement.
Virtual Reality Exposure Therapy
Suggested – for addressing the needs of patients dealing with PTSD. Indications include experiencing PTSD symptoms that necessitate therapeutic intervention. The recommended frequency involves sessions lasting 90 minutes, occurring once to twice weekly over a five-week period.
Reevaluation is advised every four weeks, with documented efficacy observed in terms of enhanced PTSD symptoms and overall functional improvement. Reasons to discontinue therapy may include the resolution of symptoms, non-compliance, adverse effects, or a lack of efficacy in treating PTSD.
Eye Movement Desensitization and Reprocessing (EMDR): Exposure Therapy and Cognitive Behavioral Therapy Components of Treatment
Suggested – for addressing the needs of patients with PTSD. The reasoning behind this recommendation lies in the fact that Eye Movement Desensitization and Reprocessing (EMDR) incorporates various therapies, or co-interventions, including those proven to be effective, such as cognitive behavioral therapy and exposure therapy.
