PTSD & Acute Trauma
Trauma- and Stressor-Related Disorders (DSM-5-TR)
Intrusions, avoidance, negative cognitions/mood, and hyperarousal following exposure to a traumatic event. Includes PTSD and acute stress disorder. Best-studied area of psychotherapy — multiple treatments have strong evidence.
Prevalence: ~6% lifetime; higher in combat veterans, assault survivors
50 Therapeutic Approaches
Sorted by evidence tier: guideline-recommended first, then RCT-supported, then emerging/limited evidence.
Guideline-Recommended (10)
Cognitive-Behavioral
CBT
Aaron Beck · 1964
Effect: g = 0.62
~50% remission
APA Div 12: Strong/Very Strong for multiple disorders. NICE: recommended for depression, all anxiety…
Attachment
Child-Parent Psychotherapy
Alicia Lieberman · 1995
California Evidence-Based Clearinghouse: highest rating (1); SAMHSA NREPP listed
Cognitive-Behavioral
CPT
Patricia Resick · 1992
Effect: d = 0.83
~50-65% remission
VA/DoD 2023: Recommended (strong). APA: Strongly recommended
Trauma-Focused
EMDR
Francine Shapiro · 1989
Effect: g = 0.66
~55-70% no longer meet PTSD criteria
VA/DoD 2023: Recommended (strong). WHO: recommended. NICE: recommended. APA: Conditionally recommend…
Cognitive-Behavioral
Imagery Rehearsal Therapy
Barry Krakow · 1995
VA/DoD: strongly recommended for nightmare disorder. AASM: recommended. APA Div 12: well-established…
Trauma-Focused
Narrative Exposure Therapy
Schauer / Neuner / Elbert · 2004
Effect: d = 0.76
~55-70% no longer meet criteria
WHO: mentioned for PTSD in conflict settings
Cognitive-Behavioral
Prolonged Exposure
Edna Foa · 1986
Effect: d = 1.08
~60-70% remission
VA/DoD 2023: Recommended (strong). NICE: recommended. APA: Strongly recommended. WHO: recommended
Cognitive-Behavioral
STAIR
Marylene Cloitre · 2002
Effect: d = 0.76 vs active control
~55-65% improvement in cPTSD
Referenced in complex PTSD treatment guidelines
Cognitive-Behavioral
TF-CBT
Cohen / Mannarino / Deblinger · 2006
Effect: d = 0.83
~60-70% remission
NICE: recommended for child PTSD. APA: recommended. SAMHSA: listed
Trauma-Focused
Written Exposure Therapy
Sloan / Marx · 2019
Effect: Non-inferior to CPT
~50-60% no longer meet criteria
VA/DoD 2023: Suggested (weak for) PTSD
RCT-Supported (28)
Trauma-Focused
Accelerated Resolution Therapy
Laney Rosenzweig · 2008
Effect: d = 1.05 (military sample)
~60-75% significant improvement
Trauma-Focused
Adaptive Disclosure
Brett Litz & colleagues · 2017
Effect: d = 0.65 for moral injury
~45-55%; especially moral injury
Somatic
Biofeedback
Various (Sterman / Schwartz / Green) · 1960
Trauma-Focused
Brainspotting
David Grand · 2003
Effect: d = 0.89 (single RCT)
~60-70% significant improvement
Cognitive-Behavioral
CBT-I
Spielman / Perlis · 1987
Family Systems
Circle of Security
Glen Cooper / Kent Hoffman / Bert Powell · 1998
Integrative
EFT Tapping
Gary Craig · 1995
Effect: d = 2.96
~60-90% no longer meet criteria
Social Justice
Feminist Therapy
Various (Lerman, Brown, Worell, Enns) · 1970
Trauma-Focused
Flash Technique
Philip Manfield · 2016
Effect: Preliminary RCT positive
Rapid SUD reduction in sessions
Cognitive-Behavioral
iCBT
Various (Andersson / Titov) · 2000
Family Systems
IFS
Richard Schwartz · 1995
Effect: d = 0.94 (single RCT)
~50-60% no longer meet criteria
Psychedelic
KAP
Various (Wolfson, Bennett) · 2010
Trauma-Focused
Lifespan Integration
Peggy Pace · 2003
Effect: Preliminary; limited RCT data
Case series suggest rapid reduction
Psychedelic
MDMA-Assisted Therapy
MAPS / Mithoefer · 2021
Effect: d = 0.91
~67% no longer met PTSD criteria
Humanistic
Play Therapy
Virginia Axline · 1947
Cognitive-Behavioral
Seeking Safety
Lisa Najavits · 2002
Somatic
Sensorimotor Psychotherapy
Pat Ogden · 1981
Effect: Preliminary; limited RCTs
Case series show body-based improvement
Somatic
Somatic Experiencing
Peter Levine · 1997
Effect: d = 0.94 (Brom et al.)
~44% remission
Trauma-Focused
Structural Dissociation
Onno van der Hart, Ellert Nijenhuis, Kathy Steele · 2006
Cognitive-Behavioral
Acceptance-Based Behavior Therapy
Lizabeth Roemer / Susan Orsillo · 2002
Somatic
Advanced Integrative Therapy
Asha Clinton · 2002
Expressive
Dance/Movement Therapy
Marian Chace · 1942
Psychedelic
EMBARK
Brennan / Belser · 2022
Cognitive-Behavioral
Metacognitive Therapy
Adrian Wells · 2009
Somatic
Neurofeedback
Barry Sterman / Joel Lubar · 1968
Crisis
Psychological First Aid
National Child Traumatic Stress Network / NCTSN · 2006
Expressive
Sandtray Therapy
Dora Kalff (Jungian) / Various · 1956
Somatic
Trauma-Sensitive Yoga
David Emerson / van der Kolk · 2005
Emerging / Limited Evidence (12)
Expressive
Art Therapy
Naumburg / Kramer · 1940
Trauma-Focused
Attachment-Focused EMDR
Laurel Parnell · 2013
Integrative
Coherence Therapy
Ecker / Hulley · 1996
Family Systems
Contextual Therapy
Ivan Boszormenyi-Nagy · 1973
Somatic
Craniosacral Therapy
John Upledger · 1970
Psychoanalytic
Ego State Therapy
John & Helen Watkins · 1997
Psychedelic
Holotropic Breathwork
Stanislav Grof / Christina Grof · 1976
Somatic
Polyvagal-Informed Therapy
Porges / Dana · 2011
Somatic
Primal Therapy
Arthur Janov · 1970
Psychedelic
PSIP
Saj Razvi · 2016
Psychedelic
Psychedelic Harm Reduction & Integration (PHRI)
Various (Gorman, Nielson, Gael) · 2015
Expressive
Psychodrama
Jacob Moreno · 1921
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