Prolonged Exposure Therapy For PTSD: Therapist Guide
Traumatic events occur frequently, with up to 60% of the US population exposed to at least one traumatic event in their lifetime (Kessler et al, 1995). The National Comorbidity Survey (2005) found lifetime rates of PTSD in the general US population of 3.6% for men and 9.7% for women.
Prolonged Exposure (PE) emerged from the adaptation and extension of Emotional Processing Theory (EPT) to PTSD. The overall aim of the treatment is to help trauma survivors to emotionally process their traumatic experiences to diminish or eliminate PTSD and other trauma-related symptoms. PE has been tested in hundreds of efficacy studies which have demonstrated that PE is highly effective at ameliorating the symptoms of PTSD, depression, anxiety, guilt, and suicidal behavior.
Prolonged Exposure Therapy For PTSD is a comprehensive program to assist clinicians in delivering effective PE for PTSD. The program includes two books:
- Prolonged Exposure Therapy for PTSD: Therapist Guide details the step-by-step treatment of PTSD using PE.
- Reclaiming Your Life From A Traumatic Experience: Workbook is the companion to this therapist guide. It will help your patients to become active participants in their treatment and to learn to manage panic attacks, anxiety about panic, and avoidance of panic and agoraphobic situations.
About Treatments That Work®
Authored by leading psychologists including David Barlow, Michelle Craske and Edna Foa, Treatments That Work® is a series of manuals and workbooks based on the principles of cognitive behavioral therapy (CBT). Each pair of books – therapist guide and workbook – contains step by step procedures for delivering evidence-based psychological interventions and will help you to provide the best possible care for your clients.
At Psychology Tools, we are proud to make many of the Treatments That Work® titles available to our members. Each book is available to download chapter-by-chapter, and Psychology Tools members with a currently active subscription to our ‘Complete’ plan are licensed to share copies with their clients.
How effective is this treatment?
Psychological treatments are recommended as first-line interventions for PTSD by the American Psychiatric Association (APA) and the UK National Institute for Health and Care Excellence (NICE). Several meta-analyses of PE have indicated that PE is highly effective at ameliorating the symptoms of PTSD, depression, anxiety, guilt, suicidal ideation, and self-injurious behavior, and, in comparison with other forms of CBT, it achieved similar outcomes (Cusack et al., 2016; Lee et al., 2016; Watts et al., 2013). In comparative efficacy trials, PE has shown similar efficacy to other interventions such as Cognitive Processing Therapy (Resick et al, 2002) and EMDR (Rothbaum, Astin & Marsteller, 2005).
Chapters in Prolonged Exposure Therapy For PTSD: Therapist Guide:
- Chapter 1: Foundations of Prolonged Exposure
- Chapter 2: Assessing Trauma Survivors and Implementing PE in Practice
- Chapter 3: Session 1
- Chapter 4: Session 2
- Chapter 5: Session 3
- Chapter 6: Intermediate Sessions (From 4 up to 14)
- Chapter 7: Final Session
- Chapter 8: Tailoring Treatment to the Individual – Promoting Effective Engagement
About the authors
Edna B. Foa, is Professor of Clinical Psychology at the University of Pennsylvania and Director of the Center for the Treatment and Study of Anxiety. Dr. Foa devoted her academic career to study the psychopathology and treatment of anxiety-related disorders, primarily obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). Her research activities included the formulation of theoretical frameworks for understanding the mechanisms underlying these disorders, the development of targeted treatments for them, and elucidating treatment mechanisms that can account for their efficacy. The treatment program she has developed for PTSD sufferers has received the highest evidence for its efficacy and has been widely disseminated in the United States and around the world. Dr. Foa’s work has been recognised with numerous awards and honours, among them the Distinguished Scientific Contributions to Clinical Psychology Award from the American Psychological Association (APA) and the Lifetime Achievement Award presented by the International Society for Traumatic Stress Studies. She was named among the TIME 100 most influential people of the world.
Elizabeth A. Hembree, is Associate Professor of Psychology at the University of Pennsylvania. Dr. Hembree’s clinical work and research has been primarily focused in the area of anxiety disorders and on the psychological impact of trauma, the treatment of individuals with trauma-related disorders, and the dissemination of cognitive behavioral treatment for PTSD. She was a faculty member for 20 years in the Center for the Treatment and Study of Anxiety (CTSA), where prolonged exposure (PE) was developed. Dr. Hembree served as Director of Clinical Training in the CTSA from 1999 to 2009. She has been involved in numerous clinical trials evaluating the efficacy and effectiveness of cognitive behavioral treatments for PTSD and anxiety disorders over the past two decades, as well asproviding frequent workshop trainings in the cognitive behavioral treatment of PTSD both in the United States and abroad. She has published numerous articles and book chapters in the PTSD area and has served on the editorial boards of the Journal of Traumatic Stress and the Journal of Anxiety Disorders.
Barbara Olasov Rothbaum, is Professor of Psychiatry and Associate Vice Chair of Clinical Research at the Emory School of Medicine. Dr. Rothbaum specializes in research on the treatment of individuals with anxiety disorders, particularly focusing on PTSD. She has authored more than 300 scientific papers and chapters, published eight books on the treatment of PTSD and edited three others on anxiety, and received a Diplomate in Behavioral Psychology from the American Board of Professional Psychology. She is a past president of the International Society of Traumatic Stress Studies (ISTSS), is currently on the Scientific Advisory Boards for the Anxiety Disorders Association of America (ADAA), the National Center for PTSD (NC- PTSD), and McLean Hospital. She is on the executive committee of the Warrior Care Network and is a pioneer in the application of virtual reality to the treatment of psychological disorders. She is a fellow of the American College of Neuropsychopharmacology (ACNP), the Association for Behavioral and Cognitive Therapies (ABCT), the APA’s Division 56 (Division of Trauma Psychology), and the National Academy of Inventors (NIA). Dr. Rothbaum received the Robert S. Laufer Award for Outstanding Scientific Achievement from the ISTSS.
Sheila A. M. Rauch, is Professor in Psychiatry in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine. Dr. Rauch received her degree from the University of North Dakota in 2000. She has been conducting research and providing treatment for PTSD and anxiety disorders for more than 20 years,receiving a Diplomate in Behavioral Psychology from the American Board of Professional Psychology. Her research focuses on examination of biological and psychological mechanisms involved in the development and treatment of PTSD and on improving access to effective interventions. She has been training providers in PTSD treatment since 2000, and has published scholarly articles and book chapters in the areas of anxiety disorders and PTSD, focusing on neurobiology and factors involved in the development, maintenance, and treatment of anxiety disorders, psychosocial factors in medical settings, and the relation between physical health and anxiety. Dr. Rauch leads work on modification and adaptation of proven psychotherapeutic interventions for anxiety disorders for various populations and settings, including primary care. She holds a diplomate in Cognitive and Behavioral Psychology, is a fellow of the ABCT, and is a member of the Board of Directors and Scientific Council of the Anxiety and Depression Association of America.
Each Treatments That Work® title is published as part of a pair:
- Clients use the Workbooks which contain elements of psychoeducation, skills development, self-assessment quizzes, homework exercises, and record forms.
- Therapists use the Therapist Guides which contain step-by-step instructions for teaching clients skills and overcoming common difficulties.
Although written for the client, the exercises in the workbook are intended to be carried out under the supervision of a mental health professional. The authors suggest that the most effective implementation of these exercises requires an understanding of the principles underlying the different procedures, and that mental health professionals should be familiar with both the Reclaiming Your Life From A Traumatic Experience: Workbook and this therapist guide.
Therapists with an active subscription to a Psychology Tools ‘Complete’ plan are licensed to use Treatments That Work® titles, and to download and share chapters with their clients.
- Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., . . . Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128–141.
- Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.
- Lee, D. J., Schnitzlein, C. W., Wolf, J. P., Vythilingam, M., Rasmusson, A. M., & Hoge, C. W. (2016). Psychotherapy versus pharmacotherapy for posttraumatuc stress disorder: Systematic review and meta-analysis to determine first-line treatments. Depression and Anxiety, 33(9), 792– 806.
- Resick, P. A., Pallavi, N., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867–879.
- Rothbaum, B. O., Astin, M. C., & Marsteller, F. (2005). Prolonged expo- sure versus eye movement desensitization and reprocessing (EMDR) for PTSD rape victims. Journal of Traumatic Stress, 18, 607–616.
- Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 74(6), e551–e557.