Resources related to Prolonged Exposure Therapy for PTSD

Irene G. Powch, Ph.D.

Clinical Psychologist, PTSD Clinical Team, Portland VA Medical Center

Assistant Professor, Oregon Health & Science University

503-220-8262 x55820

Prolonged Exposure Therapy (PE) Treatment Manual:

Title: Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences, Therapist Guide

Authors: Edna B. Foa, Elizabeth A. Hembree, and Barbara Olasov Rothbaum

Published: 2007 Oxford University Press

Prolonged Exposure Therapy (PE) Workbook:

Title: Reclaiming Your Life From a Traumatic Experience Workbook

Authors: Olasov Rothbaum, Elizabeth A. Hembree, and Edna B. Foa

Published: 2007 Oxford University Press

Cognitive Therapy for Trauma (CTT) Treatment Manual:

*This treatment manual includes exposure therapy modules. It is a helpful adjunct for novice therapists because it was written to be successfully used by paraprofessionals working in battered women’s shelters. (Ex. “Millie the Dog” process of explaining the treatment rationale for in vivo exposure).

Title: Treating PTSD in Battered Women

Authors: Edward S. Kubany, Ph.D., ABPP, & Tyler C. Ralston, Psy.D.

Published: 2008 New Harbinger Publications

Cognitive Therapy for Trauma (CTT) Workbook:

*This workbook is tailored for women with PTSD related to domestic violence. It has a very compelling section on the role of avoidance in the maintenance of PTSD.

Title: Healing the Trauma of Domestic Violence: A Workbook for Women.

Authors: Edward S. Kubany, Ph.D., Mari A. McCaid, MSCP, & Janet R. Laconsay, MA.

Published: 2004 New Harbinger Publications

DVD of a 10 minute Dateline segment that includes footage of actual PE sessions with a female civilian rape survivor.

Provided with PE 40 hour training.

DVD with information about PE and several veteran post-treatment interviews.

Provided with PE 40 hour training.

DVD of a post-treatment interview with a veteran who completed PE for PTSD related to a violent rape in the military

Distribution process is currently being worked out; contact Dr. Powch.

DVD of post-treatment interviews with two veterans, a female veteran a half year after completing PE r/t a brutal rape in the military, and a male combat veteran almost 3 years after completing therapy that included in vivo exposure r/t witnessing a horrific death by friendly fire and being involved in the clean-up

MIRECC Presentation: PTSD Recovery Stories: Video Case Examples and Live Discussion with Recovered Veterans. Irene Powch, Ph.D. Available through Portland VA MIRECC office. Contact Lauren Stoner at: 503-220-3481.

Website with Links to resources related to PTSD treatment in Veterans

National Center for PTSD

Training for Civilian Providers

The Center for Deployment Psychology provides a 2-day training in PE and training in related competencies such as PTSD assessment) to civilian providers. David Riggs, Ph.D. (who was one of the trainers for the Schnur et al 2007 VA cooperative study, and held positions within VA’s National Center for PTSD as well as Dr. Foa’s Center for the Treatment and Study of Anxiety). The Board of Directors includes Dr. Joseph Ruzek of the VA National Center for PTSD in addition to representatives of the Army, Navy, Air Force, and USUHS.

301-816-4754

DVD with 6-hour training by Claudia Zayfert, Ph.D. “Effective Treatment for PTSD with Challenging Cases”

Review of the Evidence Base for Exposure Therapies (pre 2000):

Title: Practice Guidelines from the International Society for Traumatic Stress Studies: Effective Treatments for PTSD

Editors: Edna B. Foa, Terence M. Keane, and Matthew J. Friedman

Published: 2000 The Guilford Press

*Exposure Therapy was already the treatment with the strongest evidence base in 2000, but had not yet been studied in veteran or military populations.

Large Multi-site Randomized Clinical Trial that Established an Evidence Base for PE with Veterans (2007):

Title: Cognitive-Behavioral Therapy for Posttraumatic Stress Disorder in Women: A Randomized Controlled Trial

Authors: Schnurr et al.

Published: Journal of the American Medical Association, 2007, February; 297: 820-830.

Review of the Evidence Base for Prolonged Exposure Therapy (PE) specifically (2010)

Title: A Meta-analytic review of prolonged exposure for posttraumatic stress disorder

Authors: Powers et al.

Published: Clinical Psychology Review, 2010, August; 30 (6): 635-641.

Evidence for Effectiveness of PE for military combat-related PTSD and in a “real world” clinical setting rather than a randomized clinical tiral (2010)

Title: Prolonged Exposure Therapy for Combat-Related Posttraumatic Stress Disorder: An examination of treatment effectiveness for veterans of the wars in Afghanistan and Iraq.

Authors: Turek, P.W. et al

Published: Journal of Anxiety Disorders, 2010, April; 25 (3): 397-403

*Note that this is one of several studies of veterans from a variety of eras, types of traumas, co-diagnoses, and TBI status. Some (smaller than this one have been published, some are currently ongoing with promising preliminary data presented at meetings).

Evidence that reduction in PTSD symptoms precedes change in cognitions (2010)

Title: Cognitions in Prolonged Exposure Therapy on Posttraumatic Stress Disorder

Authors: Hagenaars, et al.

Published: International Journal of Clinical and Health Psychology, 2010, September; 10 (3): 421-434.

Evidence that treatment outcome is better for those who experience sudden gains

Title: A preliminary investigation o f sudden gains in exposure therapy for PTSD

Authors: Doane et al

Published: Behaviour Research and Therapy, 2010, June; 48 (6): 555-560.

Evidence that PE promotes posttraumatic growth (increased sense of New Possibilities and Personal Strength)

Title: Posttraumatic Growth in exposure therapy for PTSD

Authors: Hagenaars & Van Minnen

Published: Journal of Traumatic Stress, 2010, August; 23 (4): 504-508.

Evidence that PE results in improvements in reported physical health symptoms and social function

Title: Changes in reported physical health symptoms and social function with prolonged exposure therapy for chronic posttraumatic stress disorder

Authors: Rauch, et al.

Published: Depression and Anxiety, 2009, August; 26 (8): 732-738.