A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood

Abstract

Background: Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. Methods: We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Results: Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised; Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Conclusions: Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms.

Interpersonal Subtypes and Therapy Response in Patients Treated for Posttraumatic Stress Disorder

“…In order to explore this interaction further, the usual procedure would be to calculate and compare effect sizes. We did so, but the resultant subsample effect sizes were very inflated compared with those for the whole sample (Butollo, Karl, König, & Rosner, ), probably due to low variances in the subsamples. Therefore, we decided to present the data in the form of a figure only.…”

“…In this study, we report data collected for a study comparing the outcomes of two treatments for PTSD (Butollo et al , ). The study was performed at a university‐based outpatient clinic and was approved by the institution's ethics committee.…”

“…In this study, we report data from a sample of outpatients suffering from PTSD. Patients were randomized to receive one of two treatments, which differed in their concept of the therapeutic relationship (Butollo, Karl, König, & Rosner, ). Our first hypothesis was that the sample, at pre‐treatment, would be heterogeneous with respect to interpersonal themes.…”

Exploring memory function in earthquake trauma survivors with resting-state fMRI and machine learning

“…For example, memory impairment in mice may persist for extended periods beyond the presentation of predatory stress [8]. Besides, some studies have suggested that patients with PTSD develop impairments in working memory, delayed memory, instantaneous memory, attention, figural memory and visuospatial ability [9][10][11]. Furthermore, trauma survivors who express higher levels of early PTSD symptoms have impaired immediate figural memory and delayed figural memory, which indicates that they are more likely to develop full-blown PTSD in the future [12].…”

Difficulties in Conducting Long Term Follow Ups in Psychotherapy Research—Issues in the Literature and Data From a Randomized Therapy Comparison Study for Posttraumatic Stress Disorder

“…To our knowledge, FU data from humanistic approaches to PTSD therapy have not been published so far. We recently compared one such therapy, dialogical exposure therapy (DET) with CPT in a randomized trial including adults with PTSD (Butollo et al, 2016). DET is an integrative treatment with a foundation in gestalt therapy.…”