**5.2 New treatments**

42 Post Traumatic Stress Disorders in a Global Context

divided into three phases and is typically administered over the course of 12 sessions. In addition, the treatment can be used in individual or group therapy. The three phases are comprised of: education, processing, and challenging. During the education phase, clients learn about the symptoms of posttraumatic stress disorder, how treatment will work, and is taught about the interaction between thoughts and feelings. They are also asked to consider how the event has impacted their outlook on the world. More specifically they are asked to examine the changes that may have occurred in their beliefs about themselves, others, and how the world operates. During the processing phase, the client is asked to either write about or discuss the traumatic event and work to identify thinking patterns that may be hindering their recovery. In the final phase of therapy, the challenging phase, the therapist works with the client to help them reframe their distorted beliefs about themselves, others, and the world. In doing this, the client develops a more

*Prolonged exposure therapy* was designed specifically for individuals with posttraumatic stress disorder. The length of treatment typically ranges from 8 to 15 sessions, although it was initially designed to be 10 sessions (Foa & Kozak, 1986; Foa et al., 2007). This treatment draws from cognitive behavioral theories and it operates on the assumption that exposure to a feared stimulus will eventually extinguish the fear. During the first and second session, the primary focus is to provide psycho-education regarding the techniques that will be used, explain the rationale for using those techniques, and discuss the ways that people typically react to a traumatic event. Subsequent sessions will be dedicated to either imagery exposure or in vivo exposure. *In vivo exposure* is where the client goes out into the real world and encounters the feared object or situation in person with the goal of habituation. The in vivo scenarios that are used during treatment are low risk and are often commonplace experiences. These scenarios are appropriate for treatment because individuals with posttraumatic stress disorder will often avoid an array of low threat situations because they trigger unpleasant memories. *Imagery exposure* involves the person imagining the feared situation. More specifically, the client is prompted to talk about the most disturbing aspects of their trauma with the therapist. This gives them the ability to reprocess what actually happened and the opportunity to reorganize how they reflect on the traumatic event. The length of treatment depends on the client and is terminated when they no longer have

Due to the biological component of posttraumatic stress disorder, individuals who suffer from the disorder can also receive antidepressants to help ameliorate their symptoms. Medication can be used in conjunction with psychotherapy or can be used alone. Although a number of medications are currently being investigated for the treatment of posttraumatic stress disorder, the Food and Drug Administration has only approved two medications (Friedman & Davidson, 2007). Both of the medications that they approved, Sertraline and Paroxetine, are selective serotonin reuptake inhibitors. As we learn more about the biological mechanisms of the disorder the medications that are recommended for

symptoms that inhibit them from engaging in every day activities.

posttraumatic stress disorder will continue to change.

balanced view of their environment.

**5.1.2 Prolonged exposure therapy** 

**5.1.3 Medication** 

Although there is limited research on novel treatments for posttraumatic stress disorder, some treatments are showing promising results. Two of those treatments include heart rate variability biofeedback training and virtual reality exposure therapy.
