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: ~6.8% lifetime and ~3.6% past year (NIMH, from NCS-R); ~9.7% lifetime in women versus ~3.6% in men; higher still in combat veterans and assault survivors
Clinical Picture
PTSD treatment has more high-quality evidence behind it than almost any other condition in psychotherapy research. The three treatments with the strongest evidence (CPT, Prolonged Exposure, and EMDR) work through different mechanisms but converge on the same principle: the traumatic memory must be accessed and processed rather than avoided. Where they diverge is in how processing happens. PE uses repeated narrative exposure. CPT works through written accounts and cognitive restructuring of 'stuck points.' EMDR uses bilateral stimulation during trauma reprocessing. The clinical question isn't which is 'best' in the abstract but which fits this client's presentation, tolerance for distress, and cognitive style.
Treatment Considerations
For single-incident adult trauma with clear PTSD symptoms, any of the guideline-recommended treatments is a reasonable starting point. The choice often depends on practical factors: PE requires homework (daily listening to session recordings); CPT requires written work; EMDR requires less between-session work but demands the client's capacity to tolerate dual attention. For clients with significant dissociation, avoidance, or complex trauma histories, a stabilization phase may be necessary before trauma processing begins. The somatic and attachment-focused approaches listed in the emerging evidence tier may be more appropriate as primary treatments for developmental or complex trauma.
Approaches and Evidence
Of 51 associated approaches, 16 have completed assessments for this topic, 11 have source checks awaiting assessment, and 24 have neither recorded yet. Each completed assessment states its population and rationale; source checks alone do not establish effectiveness. These categories describe different findings and review stages; they are not a ranking of treatments. 3 frameworks are shown separately.
Guideline recommendation (5)
These assessments record a guideline recommendation for the stated population. Read the scope and rationale; a broad topic label does not make a recommendation applicable to everyone.
Cognitive Processing Therapy
Patricia Resick · 1992
Reviewed population: Adults with PTSD receiving individual, manualized Cognitive Processing Therapy (CPT). This assessment does not grade all acute post-trauma symptoms, prevention after exposure, childhood PTSD or every adaptation of the protocol.
VA/DoD 2023 recommendation 8 strongly recommends individual, manualized CPT for adult PTSD. The American Psychological Association’s 2025 guideline also strongly recommends CPT compared with no intervention or usual care (printed p. 7). NICE NG116 (2018) recommendation 1.6.16 names it among individual trauma-focused CBT options after more than one month. These recommendations do not establish that CPT is superior to every active psychotherapy or validate the catalogue’s legacy response rates.
Reviewed
- VA/DoD (2023): Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder — Recommendation 8; Table 6, printed/PDF p. 36; discussion pp. 46–49
- American Psychological Association (Approved by APA Council of Representatives, February 2025): Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults — Tier definitions, printed p. 6 / physical PDF p. 10; psychological recommendations, printed p. 7 / physical PDF p. 11; active comparisons, printed p. 9 / physical PDF p. 13; university-hosted copy
- NICE (2018-12-05): Post-traumatic stress disorder (NG116) — Recommendations 1.6.16–1.6.17, printed/physical PDF p. 20
Guidelines and official sources (4)
3 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
CPT is explicitly strongly recommended.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends CPT as a first-line adult PTSD treatment compared with no intervention or treatment as usual.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The evidence profile includes CPT within individual trauma-focused CBT. STR1 recommends that category conditionally; this is not a separately graded recommendation for CPT.
Scope: Adults with PTSD.
Eye Movement Desensitization and Reprocessing
Francine Shapiro · 1989
Reviewed population: Adults with PTSD receiving individual, manualized EMDR. This does not grade acute post-trauma prevention, pediatric care, attachment-focused EMDR, ketamine-assisted EMDR or other branded adaptations.
VA/DoD 2023 recommendation 8 strongly recommends EMDR for adult PTSD. The American Psychological Association’s 2025 guideline gives a conditional recommendation versus no intervention or usual care. For non-combat-related trauma, NICE NG116 (2018) offers EMDR after more than three months and considers it at one to three months when preferred. WHO STR1 is conditional; its 2023 book reports low certainty while its web summary reports moderate quality, an unresolved discrepancy. These differences remain visible: the label records a guideline recommendation for this adult PTSD protocol, not unanimous recommendation strength, universal first-line status or a claim that EMDR is unsuitable after combat trauma.
Reviewed
- VA/DoD (2023): Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder — Recommendation 8; Table 6, printed/PDF p. 36; discussion pp. 46–49
- American Psychological Association (Approved by APA Council of Representatives, February 2025): Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults — Tier definitions, printed p. 6 / physical PDF p. 10; psychological recommendations, printed p. 7 / physical PDF p. 11; active comparisons, printed p. 9 / physical PDF p. 13; university-hosted copy
- NICE (2018-12-05): Post-traumatic stress disorder (NG116) — EMDR recommendations 1.6.18–1.6.20, printed/physical PDF p. 21
- World Health Organization (Third edition, 20 November 2023): Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders — STR1, printed p. 46 / PDF p. 78; executive summary p. xxii / PDF p. 24
- World Health Organization (2023 update; current HTML read 6 September 2026): Posttraumatic stress disorder (PTSD): psychological interventions – adults — Recommendation, strength and quality-of-evidence fields
Guidelines and official sources (7)
7 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
EMDR is explicitly strongly recommended.
Scope: Adults with PTSD
- Post-traumatic stress disorder (NG116)
Recommendation for the stated population
For adults, NICE considers EMDR at 1–3 months if preferred and offers it after 3 months for non-combat trauma. This scope is not a contraindication for combat trauma.
Scope: Adults after non-combat trauma; separate restricted option for ages 7–17
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA conditionally recommends EMDR as a second-line adult PTSD treatment compared with no intervention or treatment as usual.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer EMDR over those comparators. Its recommendation versus no treatment or usual care does not establish superiority over active therapy.
Scope: Adults with PTSD; EMDR versus the other active psychological treatments listed in the table.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes EMDR in a conditional recommendation. The 2023 guideline book rates certainty as low, while WHO’s web summary reports moderate quality; that discrepancy remains unresolved. Delivery requires appropriate training and supervision.
Scope: Adults with PTSD, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes EMDR in a strong recommendation based on moderate-certainty evidence. Clinicians need relevant training and demonstrated competence; lay providers require comprehensive training and close supervision.
Scope: Children and adolescents with PTSD.
Narrative Exposure Therapy
Schauer / Neuner / Elbert · 2004
Reviewed population: Adults with PTSD receiving NET.
ISTSS 2018 gives NET a Standard recommendation. VA/DoD 2023 remains inconclusive; recommendations differ.
Reviewed
Guidelines and official sources (5)
3 clinical guideline checks · 2 professional reference checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Evidence summary: psychological treatments for PTSD in adults
Recommendation for the stated population
ISTSS gives NET a Standard recommendation, distinct from its Strong category.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA conditionally recommends NET as a second-line adult PTSD treatment.
Scope: NET for adults with PTSD compared with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against NET for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
NET is included in the trauma-focused CBT evidence grouping. This does not establish a separate WHO conflict-settings recommendation.
Scope: Adults with PTSD
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The evidence profile includes kidNET in individual trauma-focused CBT. The strong STR2 recommendation concerns the treatment category, rather than a separate rating for kidNET or adult NET.
Scope: Children and adolescents with PTSD; the review includes kidNET.
Prolonged Exposure Therapy
Edna Foa · 1986
Reviewed population: Adults with PTSD receiving individual, manualized Prolonged Exposure (PE). This assessment does not grade all acute post-trauma symptoms, prevention after exposure, childhood PTSD or every adaptation of the protocol.
VA/DoD 2023 recommendation 8 strongly recommends individual, manualized PE for adult PTSD. The American Psychological Association’s 2025 guideline also strongly recommends PE compared with no intervention or usual care (printed p. 7). NICE NG116 (2018) recommendation 1.6.16 names it among individual trauma-focused CBT options after more than one month. These recommendations do not establish that PE is superior to every active psychotherapy or validate the catalogue’s legacy response rates.
Reviewed
- VA/DoD (2023): Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder — Recommendation 8; Table 6, printed/PDF p. 36; discussion pp. 46–49
- American Psychological Association (Approved by APA Council of Representatives, February 2025): Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults — Tier definitions, printed p. 6 / physical PDF p. 10; psychological recommendations, printed p. 7 / physical PDF p. 11; active comparisons, printed p. 9 / physical PDF p. 13; university-hosted copy
- NICE (2018-12-05): Post-traumatic stress disorder (NG116) — Recommendations 1.6.16–1.6.17, printed/physical PDF p. 20
Guidelines and official sources (7)
6 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
PE is one of three specifically named strongly recommended trauma-focused psychotherapies.
Scope: Adults with PTSD
- Post-traumatic stress disorder (NG116)
Recommendation for the stated population
NICE explicitly includes PE among trauma-focused CBT interventions.
Scope: Adults with clinically important PTSD symptoms; timing and diagnosis determine the recommendation
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends PE as a first-line adult PTSD treatment compared with no intervention or treatment as usual.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer PE over those comparators. Its recommendation versus no treatment or usual care does not establish superiority over active therapy.
Scope: Adults with PTSD; PE versus the other active psychological treatments listed in the table.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends this combination; the table includes PE plus usual care and the COPE protocol.
Scope: Adults with PTSD and co-occurring SUD; PE-based treatment plus usual SUD care versus usual SUD care alone.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The WHO evidence review includes PE within individual trauma-focused CBT. The clinical recommendation is for that class, not a separately graded PE recommendation.
Scope: Adults with PTSD
Written Exposure Therapy
Sloan / Marx · 2019
Reviewed population: Adults with PTSD; individual manualized WET.
VA/DoD 2023 recommendation 9 suggests WET (weak for).
Reviewed
Guidelines and official sources (5)
4 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
VA/DoD suggests WET with a weak recommendation. The recommendation does not independently validate numerical outcome claims.
Scope: Adults with PTSD; individual, manualized Written Exposure Therapy.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD suggests co-occurring disorders should not preclude these PTSD treatments. This addresses access to treatment, not a separate claim of treating substance use.
Scope: PTSD with co-occurring substance-use disorder or other disorders; therapies named in recommendations 8 and 9.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for this efficacy comparison. Its separate comparisons with active treatments reach a different evidentiary finding.
Scope: Adults with PTSD; WET versus waitlist or usual care.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports no difference in effect and makes no recommendation between these treatments. This is distinct from the insufficient-evidence finding versus waitlist or usual care.
Scope: Adults with PTSD; WET versus CPT, CPT with account, or PE.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The evidence profile includes written exposure therapy within individual trauma-focused CBT. STR1 recommends that category conditionally; this is not a separately graded recommendation for written exposure therapy.
Scope: Adults with PTSD.
Randomized studies (6)
These assessments describe randomized studies in the stated population. Randomized studies may include pilot or null findings; this label alone does not establish benefit.
Art Therapy
Naumburg / Kramer · 1940
Reviewed population: Veterans in residential treatment for combat-related PTSD receiving adjunctive individual art therapy plus CPT, versus CPT alone.
Campbell and colleagues (2016) report random assignment by treatment-entry time: 15 assigned and 11 completed. Both arms improved without a significant between-group symptom difference. This small adjunctive study does not establish standalone art-therapy efficacy; allocation and attrition limit interpretation.
Reviewed
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD gives creative arts therapies a neutral recommendation, naming art as an example. Specific protocols are not separately graded.
Scope: Creative arts therapies for adults with PTSD.
Deep Brain Reorienting
Frank Corrigan · 2020
Reviewed population: 54 adults with PTSD randomized to eight videoconference DBR sessions or waitlist.
Kearney and colleagues (2023) report an interim randomized analysis with greater clinician-rated PTSD improvement for DBR at post-treatment and three-month follow-up. The small waitlist-controlled study does not establish comparative efficacy against established active therapies or confirm its proposed neural mechanism.
Reviewed
Flash Technique
Philip Manfield · 2016
Reviewed population: Adult traffic-accident survivors with traumatic-stress symptoms; a PTSD diagnosis was not required.
Yaşar et al. (2022) randomized 68 participants to online group Flash or stress-management psychoeducation; only 39 completers were analyzed. Some self-reported traumatic-stress outcomes favored Flash at one month. Attrition, short follow-up and absent preregistration limit interpretation. This is not evidence of diagnostic remission, equivalence to standard EMDR, or effectiveness for complex PTSD.
Reviewed
Internal Family Systems
Richard Schwartz · 1995
Reviewed population: Adults with PTSD receiving 16-week online IFS-based PARTS groups plus eight individual counseling sessions.
Joss and colleagues (2026) randomized 60 patients to PARTS or matched nature-based stress reduction. Both arms improved on clinician-rated PTSD without a significant between-arm difference; PARTS had higher attendance and satisfaction. This supports existence of a randomized study, not superiority or evidence for unrestricted individual IFS.
Reviewed
Trauma-Focused Cognitive Behavioral Therapy
Cohen / Mannarino / Deblinger · 2006
Reviewed population: Children aged 8–14 with sexual-abuse-related PTSD symptoms and their primary caregivers; 89% met full DSM-IV PTSD criteria.
Cohen and colleagues (2004) randomized 229 children/caregivers to the specific TF-CBT protocol or child-centered therapy. TF-CBT produced greater PTSD symptom improvement. This supports the named child protocol, without inheriting adult trauma-focused-CBT family recommendations.
Reviewed
Guidelines and official sources (4)
2 clinical guideline checks · 2 professional reference checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Post-traumatic stress disorder (NG116)
Discussed in the source
NICE offers individual trauma-focused CBT to ages 7–17 after 3 months and considers it for other specified child groups. The umbrella wording does not independently name every branded protocol.
Scope: Ages 5–17 with PTSD or clinically important symptoms; age and time since trauma matter
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA recommends the trauma-focused CBT family for adults. Footnote 4 explicitly defines a broad grouping, not a specific therapy; this does not establish a child Cohen TF-CBT recommendation.
Scope: Adults with PTSD; comparison with no intervention or treatment as usual
- Trauma-focused cognitive behavioral therapy: NCTSN resource listing
Discussed in the source
SAMHSA lists the NCTSN TF-CBT resource. A resource listing is not a graded CPG recommendation.
Scope: TF-CBT information for children/adolescents and caregivers
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The review includes trauma-focused CBT for children and caregivers in a broader trauma-focused CBT category. WHO explicitly distinguishes that broad label from the specific Cohen protocol; STR2 does not separately grade the named protocol.
Scope: Children and adolescents with PTSD.
Trauma-Sensitive Yoga
David Emerson / van der Kolk · 2005
Reviewed population: Women veterans with military-sexual-trauma-related PTSD receiving the named Trauma Center Trauma-Sensitive Yoga protocol versus group CPT; 131 in the intention-to-treat sample.
Zaccari and colleagues (2023) found PTSD improvement in both arms without significant group differences and higher TCTSY completion. Equivalence analyses were added after the null difference analyses; assessors were unblinded. This records a protocol-specific trial, not guideline endorsement. The separately recorded APA 2025 inconclusive source check is retained and was not superseded by this study assessment.
Reviewed
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD finds insufficient evidence for or against yoga. This broad category does not separately grade a specific trauma-sensitive-yoga protocol.
Scope: Yoga as an intervention for adult PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA explicitly lists group trauma-sensitive yoga and finds insufficient evidence to recommend for or against it.
Scope: Group trauma-sensitive yoga for adults with PTSD
Guideline evidence inconclusive (5)
The named guideline review found insufficient evidence to recommend for or against the specified use, population and outcomes. This is a completed guideline assessment, not a finding of ineffectiveness or a review of the entire literature.
Accelerated Resolution Therapy
Laney Rosenzweig · 2008
Reviewed population: Adults with PTSD.
VA/DoD 2023 recommendation 10 finds evidence insufficient for or against Accelerated Resolution Therapy.
Reviewed
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for a recommendation for or against ART. Emerging is not the recommendation’s strength label.
Scope: Accelerated Resolution Therapy for adult PTSD treatment.
Adaptive Disclosure
Brett Litz & colleagues · 2017
Reviewed population: Adults with PTSD.
VA/DoD 2023 recommendation 10 finds evidence insufficient for or against Adaptive Disclosure.
Reviewed
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
Adaptive Disclosure is explicitly listed among therapies with insufficient evidence for or against their use for PTSD. It is not absent from the guideline.
Scope: Adaptive Disclosure for adults with PTSD.
Imagery Rehearsal Therapy
Barry Krakow · 1995
Reviewed population: Adults with PTSD-associated nightmares.
VA/DoD 2023 recommendation 33 is inconclusive. AASM’s 2018 position paper recommends IRT for nightmares; it is not a graded CPG or a recommendation for all PTSD symptoms.
Reviewed
Guidelines and official sources (3)
2 clinical guideline checks · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against IRT for nightmares associated with PTSD.
Scope: Nightmares associated with PTSD
- Position paper for the treatment of nightmare disorder in adults
Recommendation for the stated population
AASM recommends IRT for these nightmare presentations. It calls this a position paper, not a graded CPG.
Scope: Adults with nightmare disorder or PTSD-associated nightmares
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for or against IRT for adult PTSD relative to no intervention or treatment as usual. This is a different scope from AASM’s nightmare-specific position.
Scope: IRT for adults with PTSD compared with no intervention or treatment as usual
Neurofeedback
Joe Kamiya / Barry Sterman / Joel Lubar · 1968
Reviewed population: Adults with PTSD.
VA/DoD 2023 recommendation 24 finds evidence insufficient for or against neurofeedback.
Reviewed
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against neurofeedback for PTSD.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for or against neurofeedback for adult PTSD relative to no intervention or treatment as usual.
Scope: Neurofeedback for adults with PTSD compared with no intervention or treatment as usual
Somatic Experiencing
Peter Levine · 1997
Reviewed population: Adults with PTSD.
VA/DoD 2023 recommendation 27 finds evidence insufficient for or against Somatic Experiencing.
Reviewed
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against somatic experiencing for PTSD.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend for or against somatic experiencing for adult PTSD.
Scope: Somatic experiencing for adults with PTSD
Source checks available — assessment pending (11)
Sources have been checked for this topic, but a condition-specific assessment has not been completed. Open the source notes to read each document’s population, recommendation and limitations.
Attachment-Focused Eye Movement Desensitization and Reprocessing
Laurel Parnell · 2013
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Post-traumatic stress disorder (NG116)
Discussed in the source
The recommendation specifies EMDR delivered using a validated manual. It does not name attachment-focused EMDR or validate automatic transfer to this adaptation.
Scope: EMDR for adult PTSD after non-combat trauma; validated manual required
Cognitive Behavioral Therapy
Aaron Beck · 1964
Guidelines and official sources (8)
8 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Post-traumatic stress disorder (NG116)
Recommendation for the stated population
NICE recommends trauma-focused CBT protocols, including CPT, cognitive therapy for PTSD, NET and PE; generic CBT is too imprecise.
Scope: Adults with acute stress disorder or clinically important PTSD symptoms; time since trauma matters
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD strongly recommends CPT, EMDR and PE by name. This does not give every form of CBT the same recommendation.
Scope: Adults with PTSD
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends the trauma-focused CBT family for adult PTSD. Footnote 4 defines a broad grouping, not a specific therapy.
Scope: Adults with PTSD; trauma-focused CBT family compared with no intervention or treatment as usual
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
VA/DoD weakly suggests trauma-focused cognitive behavioral psychotherapy for PTSD prevention in acute stress disorder. This is distinct from immediate support for everyone exposed to trauma.
Scope: Adults diagnosed with acute stress disorder; prevention of subsequent PTSD.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer trauma-focused CBT over those comparators. Its recommendation versus no treatment or usual care does not establish superiority over active therapy.
Scope: Adults with PTSD; trauma-focused CBT versus the other active psychological treatments listed in the table.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Recommendation for the stated population
APA strongly recommends adding trauma-focused treatment in this specific combined-care comparison.
Scope: Adults with PTSD and co-occurring SUD; trauma-focused CBT plus usual SUD care versus usual SUD care alone.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes individual, group and digital trauma-focused CBT in a conditional recommendation. The 2023 guideline book rates certainty as low, while WHO’s web summary reports moderate quality; that discrepancy remains unresolved. Delivery requires appropriate training and supervision.
Scope: Adults with PTSD, within the mhGAP non-specialist-care context.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Recommendation for the stated population
WHO includes individual and group face-to-face trauma-focused CBT in a strong recommendation based on moderate-certainty evidence. Clinicians need relevant training and demonstrated competence; lay providers require comprehensive training and close supervision.
Scope: Children and adolescents with PTSD.
Child-Parent Psychotherapy
Alicia Lieberman · 1995
Guidelines and official sources (1)
1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Child-Parent Psychotherapy: program ratings
Not a treatment recommendation
CEBC rates CPP 1 for infant and early-childhood mental health, and 2 for child/adolescent trauma and domestic-violence services. These are topic-specific registry ratings, not clinical guideline recommendations.
Scope: Children aged 0–5 who have experienced trauma and their caregivers.
Dance/Movement Therapy
Marian Chace · 1942
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD gives creative arts therapies a neutral recommendation, naming dance as an example. Specific protocols are not separately graded.
Scope: Creative arts therapies for adults with PTSD.
Emotional Freedom Techniques (EFT Tapping)
Gary Craig · 1995
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
The guideline explicitly finds insufficient evidence for or against Emotional Freedom Techniques for PTSD. Inclusion is not a positive recommendation.
Scope: Emotional Freedom Techniques for adults with PTSD.
Internet-Delivered Cognitive Behavioral Therapy
Various (Andersson / Titov) · 2000
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against facilitated internet-based CBT for PTSD. Validated video-delivered therapies have a different recommendation.
Scope: Facilitated internet-based CBT for adults with PTSD.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
Digital or remote trauma-focused CBT is included in the conditional recommendation, based on low-certainty evidence. This is a format-and-treatment-class recommendation, not an endorsement of every internet CBT program.
Scope: Adults with PTSD.
Ketamine-Assisted Psychotherapy
Various (Wolfson, Bennett) · 2010
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD weakly recommends against ketamine for PTSD. The statement concerns medication and does not separately evaluate KAP.
Scope: Ketamine pharmacotherapy for adult PTSD; not a separate KAP psychotherapy assessment.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports insufficient evidence for ketamine in these comparisons. This is a drug-level finding, not a separate evaluation of the KAP psychotherapy protocol.
Scope: Adults with PTSD; ketamine compared with an active or inactive intervention.
MDMA-Assisted Therapy
MAPS / Mithoefer · 2021
Guidelines and official sources (3)
2 clinical guideline checks · 1 regulatory source check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- NDA 215455: midomafetamine complete response letter
Not a treatment recommendation
The letter verifies the 2024 nonapproval decision and identifies safety reporting, durability and bias concerns. Psychotherapy-contribution questions appear separately as additional comments.
Scope: Midomafetamine application NDA 215455 for PTSD
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against MDMA-assisted psychotherapy. The guideline’s evidence cutoff precedes later trials and regulatory decisions.
Scope: MDMA-assisted psychotherapy for adults with PTSD; evidence reviewed through May 2022.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for or against this intervention in the reviewed comparisons.
Scope: Adults with PTSD; MDMA-assisted psychotherapy versus the inactive or low-dose active comparators reviewed.
Metacognitive Therapy
Adrian Wells · 2009
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend for or against metacognitive therapy in this comparison.
Scope: Adults with PTSD; metacognitive therapy versus no intervention or usual care.
Seeking Safety
Lisa Najavits · 2002
Guidelines and official sources (3)
3 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds the evidence insufficient for a recommendation for or against this treatment.
Scope: Seeking Safety for adult PTSD treatment.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports no difference in effect on PTSD symptoms or substance use and makes no recommendation for or against these comparisons.
Scope: Adults with PTSD and co-occurring SUD; Seeking Safety, with or without usual care, compared with usual SUD care.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer either side of these active-treatment comparisons.
Scope: Adults with PTSD and co-occurring SUD; Seeking Safety compared with COPE or Creating Change in the reviewed care arrangements.
Skills Training in Affective and Interpersonal Regulation
Marylene Cloitre · 2002
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds the evidence insufficient for a recommendation for or against STAIR. This is not a positive recommendation for complex PTSD.
Scope: STAIR for adult PTSD treatment.
Assessment not yet completed (24)
No completed assessment or source check for this topic is recorded yet.
Acceptance-Based Behavior Therapy
Lizabeth Roemer / Susan Orsillo · 2002
Advanced Integrative Therapy
Asha Clinton · 2002
Biofeedback
Various (Neal Miller / Kamiya / Green / Sterman / Schwartz) · 1960
Brainspotting
David Grand · 2003
Cognitive Behavioral Therapy for Insomnia
Bootzin / Spielman / Morin / Perlis · 1987
Circle of Security
Glen Cooper / Kent Hoffman / Bert Powell / Robert Marvin · 1998
Coherence Therapy
Ecker / Hulley · 1996
Contextual Therapy
Ivan Boszormenyi-Nagy · 1973
Craniosacral Therapy
John Upledger · 1970
Ego State Therapy
John & Helen Watkins · 1997
EMBARK
Brennan / Belser · 2022
Feminist Therapy
Various (Lerman, Brown, Worell, Enns) · 1970
HeartMath
Doc Childre · 1991
Holotropic Breathwork
Stanislav Grof / Christina Grof · 1976
Ketamine-Assisted Eye Movement Desensitization and Reprocessing
Danielle Ciccone & Michele Topel · 2024
Lifespan Integration
Peggy Pace · 2003
Play Therapy
Virginia Axline · 1947
Primal Therapy
Arthur Janov · 1970
Psychedelic Somatic Interactional Psychotherapy
Saj Razvi · 2016
Psychedelic Harm Reduction and Integration
Various (Gorman, Nielson and colleagues) · 2021
Psychodrama
Jacob Moreno · 1921
Psychological First Aid
National Child Traumatic Stress Network / NCTSN · 2006
Sandtray Therapy
Dora Kalff (Jungian) / Various · 1956
Sensorimotor Psychotherapy
Pat Ogden · 1981
Associated Frameworks (3)
These are conceptual or research frameworks. They are not ranked as treatment evidence.
Common Factors / Contextual Model
Saul Rosenzweig / Jerome Frank / Bruce Wampold · 1936
Polyvagal-Informed Therapy
Porges / Dana · 2018
Structural Dissociation
Onno van der Hart, Ellert Nijenhuis, Kathy Steele · 2006
Additional Source References (14)
These source checks also address this topic. They are listed separately from the catalogue associations above. Read each source’s scope and direction; a mention may concern a related intervention or a neutral recommendation.
Acceptance and Commitment Therapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against ACT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
Behavioral Activation
Guidelines and official sources (2)
1 clinical guideline check · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence for BATD in this PTSD comparison. This does not determine its depression-treatment status.
Scope: Adults with PTSD; Behavioral Activation Treatment for Depression (BATD) versus no intervention or usual care.
- mhGAP evidence profile STR1/STR2: PTSD psychological interventions
Discussed in the source
The evidence profile includes behavioral activation for PTSD within individual trauma-focused CBT. STR1 recommends that category conditionally; this is not a separately graded recommendation for behavioral activation for PTSD.
Scope: Adults with PTSD.
Clinical Hypnotherapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against hypnosis or self-hypnosis for PTSD.
Scope: Adults with PTSD; mind-body interventions.
Dialectical Behavior Therapy
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against DBT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend one of these treatment arrangements over the other. This does not assess DBT for BPD.
Scope: Adults with PTSD; DBT plus PE versus DBT alone.
Emotion-Focused Therapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports insufficient evidence versus no intervention or usual care for this specific variant, rather than every emotion-focused therapy.
Scope: Adults with PTSD; the emotion-focused imaginal-confrontation intervention reviewed by the panel.
Interpersonal Psychotherapy
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against IPT for PTSD. This assessment does not determine its status for other conditions.
Scope: Individual psychotherapy for adults with PTSD.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend for or against IPT in this comparison.
Scope: Adults with PTSD; IPT versus no intervention or usual care.
Mindfulness-Based Cognitive Therapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against MBCT for PTSD.
Scope: Adults with PTSD; mind-body interventions.
Mindfulness-Based Stress Reduction
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Recommendation for the stated population
VA/DoD suggests MBSR with a weak recommendation. This PTSD recommendation does not establish support for every other condition linked to MBSR.
Scope: Adults with PTSD; MBSR as a complementary/integrative intervention.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to recommend for or against MBSR in this comparison.
Scope: Adults with PTSD; MBSR versus no intervention or usual care.
Motivational Enhancement Therapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Insufficient evidence for or against
APA finds insufficient evidence to prefer sequential over concurrent delivery, or vice versa. This is not a recommendation about MET alone.
Scope: Adults with PTSD and co-occurring SUD; MET followed by PE versus MET delivered with PE.
Music Therapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD gives creative arts therapies a neutral recommendation, naming music as an example. Specific protocols are not separately graded.
Scope: Creative arts therapies for adults with PTSD.
Psilocybin-Assisted Therapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD finds insufficient evidence for or against psilocybin for PTSD. The statement does not separately establish a psychotherapy-protocol recommendation.
Scope: Psilocybin pharmacotherapy for adult PTSD; evidence reviewed through May 2022.
Psychoanalysis
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD gives psychodynamic therapy a neutral recommendation for PTSD. The category does not independently establish findings for every psychodynamic protocol.
Scope: The psychodynamic-therapy category for adult PTSD; no separate grade for this specific approach.
Short-Term Psychodynamic Psychotherapy
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD gives psychodynamic therapy a neutral recommendation for PTSD. The category does not independently establish findings for every psychodynamic protocol.
Scope: The psychodynamic-therapy category for adult PTSD; no separate grade for this specific approach.
- Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults
Discussed in the source
APA reports insufficient evidence for this category. The statement does not separately evaluate every short-term psychodynamic protocol.
Scope: Adults with PTSD; the psychodynamic-therapy category versus no intervention or usual care.
Supportive Psychotherapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for Management of PTSD and Acute Stress Disorder
Discussed in the source
VA/DoD finds insufficient evidence for or against supportive counseling for PTSD; the recommendation does not individually assess every supportive-psychotherapy model.
Scope: Supportive counseling for adults with PTSD.
Cases Featuring Associated Approaches
These teaching cases share approach links with this topic. They may illustrate a different presenting concern.
Reading This Page
Why are these approaches listed with PTSD & Acute Trauma?
The catalogue associates 51 approaches and 3 frameworks with this topic. These links support learning and comparison; association alone is not a treatment recommendation or evidence of effectiveness.
How should I read the evidence assessments?
Assessments are specific to the population and scope stated on each card. They include a rationale, source links, and a review date. An overall review of an approach does not automatically apply to this condition, and a randomized-study label does not by itself mean that a study found benefit.
What does "Assessment not yet completed" mean?
A condition-specific assessment has not been recorded. Approaches with checked sources appear in a separate assessment-pending group; a checked source can support, oppose, or discuss an intervention without recommending it. Neither pending group means that no research exists or that the approach is ineffective. Frameworks are shown separately.
Sources and Review Scope
Source links and dates on assessment cards apply to the stated population and rationale. The clinical overview and prevalence text above are separate authored content; an approach's evidence label does not verify those statements. Recorded narrative notes and citations remain available on individual modality pages, with their review status identified. The bibliography provides further reading.