Abstract

As a hidden epidemic, trauma is a serious public health concern that negatively affects individuals and communities globally. There have been ongoing debates and conflictual guidelines surrounding how mental health professionals diagnose trauma, and what would be empirically supported treatment (EST) approaches to address trauma. With the aim of informing the clinical decision-making process, this study critically reviews and synthesizes published empirical research on psychological treatments of post-traumatic stress disorder (PTSD). A form of rapid evidence assessment was conducted to map out the existing literature on psychological treatments for PTSD, considering client demographics, types of trauma, therapy modes, and service delivery and intensity. All studies included in the final review (N = 14) are mostly systematic review or meta-analysis. In total, our review encompassed 486 ESTs (mostly RCTs = 474 and total participants =37,222). Our review was categorized into five areas: empirically supported psychological treatments in adults or children; trauma-focused or non-trauma-focused treatments; group therapies; web-based therapies; and intensity/duration of treatment. The consistent finding is that all active psychological treatments for PTSD are more effective than a waitlist. Therefore, a first line of PTSD treatment is to reduce a waitlist and provides services at the time of need. In this regard, findings on innovative service delivery, such as online approaches, delivering massed treatment options, and group therapies are promising. The study limitations, clinical implications, and areas of future research are discussed.

摘要

作为一种隐藏的流行病，创伤是一个严重的公共卫生问题，对全球个人和社区产生负面影响。关于精神卫生专业人员如何诊断创伤，以及解决创伤的经验支持治疗 (EST) 方法，一直存在争论和相互矛盾的指导方针。为了告知临床决策过程，本研究批判性地回顾和综合了已发表的关于创伤后应激障碍 (PTSD) 心理治疗的实证研究。考虑到客户人口统计、创伤类型、治疗模式以及服务提供和强度，进行了一种快速证据评估，以绘制出关于 PTSD 心理治疗的现有文献。最终评价中包含的所有研究（N = 14) 大多是系统评价或荟萃分析。总的来说，我们的审查包括 486 个 EST（主要是随机对照试验 = 474，参与者总数 = 37,222）。我们的审查分为五个方面： 经验支持的成人或儿童心理治疗；以创伤为中心或非以创伤为中心的治疗；团体疗法；基于网络的疗法；和治疗强度/持续时间。一致的发现是，所有针对 PTSD 的积极心理治疗都比等候名单更有效。因此，PTSD 治疗的第一线是减少等待名单并在需要时提供服务。在这方面，关于创新服务提供的发现，例如在线方法、提供大量治疗选择和团体治疗，是很有希望的。讨论了研究局限性、临床意义和未来研究领域。