A Comparison of Exposure Therapy, Stress Inoculation Training, and Their Combination for Reducing Posttraumatic Stress Disorder in Female Assault Victims

Foa, Edna B.; Dancu, Constance V.; Hembree, Elizabeth A.; Jaycox, Lisa H.; Meadows, Elizabeth A.; Street, Gordon P.

doi:10.1176/foc.7.2.foc290

Cited by 133 publications

(231 citation statements)

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“…These two therapies work well when compared with a wait-list control (Hogberg et al, 2006;Resick, Nishith, Weaver, Astin, & Feuer, 2002) against other forms of accepted practices for PTSD (e.g. supported counselling; Foa et al, 1999) and also when they are directly compared against each other (Devilly & Spence, 1999;Rothbaum, Astin, & Marsteller, 2005). This attests to the robustness of findings for both.…”

Section: Movement Desensitisation and Reprocessing (Emdr) Or Trauma-fmentioning

confidence: 65%

Cognitive behaviour therapy versus eye movement desensitization and reprocessing for post-traumatic disorder – is it all in the homework then?

Lee

2012

European Review of Applied Psychology

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The aim of the present meta-analysis was to determine whether there are any differences between eye movement desensitisation and reprocessing (EMDR) and trauma-focused cognitive behaviour therapy (TFCBT) for post-traumatic stress disorder (PTSD) with respect to efficacy and efficiency. We performed a comprehensive literature search using several electronic search engines as well as manual searches of other review papers. Eight original studies involving 227 participants were identified in this manner. The results showed no difference between EMDR or TFCBT on measures of PTSD. However, there was a significant advantage for EMDR over TFCBT in reducing depression (Hedge's g= .63). The analysis also indicated a difference in the prescribed homework between the treatments.Meta-regression analyses were conducted to examine the relationship between hours of homework and gains in depression and PTSD symptoms. Conclusions were confounded by differences between the treatments. These findings are discussed in terms of efficacy and cost-effectiveness. Conflict of interest:The second author receives payments for CBT and EMDR trainings.

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Section: Movement Desensitisation and Reprocessing (Emdr) Or Trauma-fmentioning

confidence: 65%

Cognitive behaviour therapy versus eye movement desensitization and reprocessing for post-traumatic disorder – is it all in the homework then?

Lee

2012

European Review of Applied Psychology

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“…Stress management training-Stress management training included procedures used by Lindsay et al (11) and was similar to stress inoculation training, a treatment effective in posttraumatic stress disorder and generalized anxiety disorder (32)(33)(34). Stress management training included two introductory sessions and 15 treatment sessions in which patients were taught stress management skills such as deep breathing, progressive muscle relaxation, positive imagery, assertiveness training, and problem solving.…”

Section: Cbtmentioning

confidence: 99%

A Randomized, Controlled Trial of Cognitive-Behavioral Therapy for Augmenting Pharmacotherapy in Obsessive-Compulsive Disorder

Simpson

Foa²,

Liebowitz³

et al. 2008

AJP

247

101

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Objective-Although serotonin reuptake inhibitors (SRIs) are approved for the treatment of obsessive-compulsive disorder (OCD), most OCD patients who have received an adequate SRI trial continue to have clinically significant OCD symptoms. The purpose of this study was to examine the effects of augmenting SRIs with exposure and ritual prevention, an established cognitive-behavioral therapy (CBT) for OCD.Method-A randomized, controlled trial was conducted at two academic outpatient clinics to compare the effects of augmenting SRIs with exposure and ritual prevention versus stress management training, another form of CBT. Participants were adult outpatients (N=108) with primary OCD and a Yale-Brown Obsessive Compulsive Scale total score ≥16 despite a therapeutic SRI dose for at least 12 weeks prior to entry. Participants received 17 sessions of CBT (either exposure and ritual prevention or stress management training) twice a week while continuing SRI pharmacotherapy.Results-Exposure and ritual prevention was superior to stress management training in reducing OCD symptoms. At week 8, significantly more patients receiving exposure and ritual prevention than patients receiving stress management training had a decrease in symptom severity of at least 25% (based on Yale-Brown Obsessive Compulsive Scale scores) and achieved minimal symptoms (defined as a Yale-Brown Obsessive Compulsive Scale score ≤12).Conclusions-Augmentation of SRI pharmacotherapy with exposure and ritual prevention is an effective strategy for reducing OCD symptoms. However, 17 sessions were not sufficient to help most of these patients achieve minimal symptoms.Obsessive-compulsive disorder (OCD) is a severe and disabling illness (1). Serotonin reuptake inhibitors (SRIs) (e.g., clomipramine and various selective serotonin re-uptake inhibitors [SSRIs]) and cognitive-behavioral therapy (CBT) involving exposure and ritual NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript prevention have both been found to be efficacious in randomized, controlled trials (2). In clinical practice, SRIs are used most frequently (3), but because they typically yield only a 20%-40% reduction in OCD symptoms (4), many SRI responders continue to have clinically significant symptoms.The only SRI augmentation strategy with proven efficacy in multiple randomized, placebocontrolled trials involves the addition of antipsychotics (e.g., haloperidol, risperidone, olanzapine, or quetiapine) (5). However, at most only half of the patients respond (i.e., experience ≥25% reduction in OCD severity) (6, 7) and antipsychotics can cause significant adverse effects (8).Because of the efficacy of exposure and ritual prevention as monotherapy for OCD (9) and promising findings from our open SRI augmentation trial using exposure and ritual prevention (10), we conducted a randomized, controlled trial to compare the effects of augmenting SRIs with exposure and ritual prevention versus stress management training, another form of CBT. Stress management training teache...

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“…Exposure-based interventions are often conducted under the general rubric of CBT, in which other techniques such as cognitive restructuring and relaxation training are integrated into the program. A number of studies support the efficacy of exposure-based therapies in various traumatized populations, including victims of accidents, natural disasters, and non-sexual assault (Bryant et al, 1999;Devilly & Spence, 1999;Marks, Lovell, Noshirvani, Livanou, & Thrasher, 1998), military combat (Keane, Fairbank, Caddell, & Zimering, 1989), and rape (Foa, Rothbaum, Riggs, & Murdoch, 1991;Foa et al, 1999).…”

Section: Therapies Of Chronic Conditionsmentioning

confidence: 99%

“First Do No Harm:” Emerging Guidelines for the Treatment of Posttraumatic Reactions

Herbert

Sageman

2004

Posttraumatic Stress Disorder

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A Comparison of Exposure Therapy, Stress Inoculation Training, and Their Combination for Reducing Posttraumatic Stress Disorder in Female Assault Victims

Cited by 133 publications

References 0 publications

Cognitive behaviour therapy versus eye movement desensitization and reprocessing for post-traumatic disorder – is it all in the homework then?

Cognitive behaviour therapy versus eye movement desensitization and reprocessing for post-traumatic disorder – is it all in the homework then?

A Randomized, Controlled Trial of Cognitive-Behavioral Therapy for Augmenting Pharmacotherapy in Obsessive-Compulsive Disorder

“First Do No Harm:” Emerging Guidelines for the Treatment of Posttraumatic Reactions

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