Alternatives to debriefing and modifications to cognitive behavior therapy for posttraumatic stress disorder

Background. Psychological debriefing uses brief unsystematic exposure, and is ineffective for posttraumatic stress symptoms and disorder. Systematic exposure alone and cognitive restructuring alone are each effective. Other approaches too may be useful. Methods:The treatment of 3 posttraumatic stress disorder (PTSD) patients is detailed in which there was no exposure to the main traumatic event. There was exposure to related cues in case 1, exposure to related and other cues followed by well-being therapy (WBT) in case 2 and WBT in case 3. Results: The 3 patients improved enduringly, confirming earlier findings that exposure to the main trauma is not essential for PTSD to improve. Conclusions: A study is needed of therapeutic mechanisms in PTSD and of the value of WBT in a randomized controlled trial. Copyright (C) 2005 S. Karger AG, Basel.