13 July 2008 – *Clinical Psychology Review* (vol. 28, #5) includes an article: “The
relative efficacy of bona fide psychotherapies for treating post-
traumatic stress disorder: A meta-analysis of direct comparisons” by
Steven Benish, Zac Imel, & Bruce Wampold.
Here’s the abstract: “Psychotherapy has been found to be an effective
treatment of post-traumatic stress disorder (PTSD), but meta-analyses
have yielded inconsistent results on relative efficacy of
psychotherapies in the treatment of PTSD. The present meta-analysis
controlled for potential confounds in previous PTSD meta-analyses by
including only bona fide psychotherapies, avoiding categorization of
psychotherapy treatments, and using direct comparison studies only. The
primary analysis revealed that effect sizes were homogenously
distributed around zero for measures of PTSD symptomology, and for all
measures of psychological functioning, indicating that there were no
differences between psychotherapies. Additionally, the upper bound of
the true effect size between PTSD psychotherapies was quite small. The
results suggest that despite strong evidence of psychotherapy
efficaciousness vis-à-vis no treatment or common factor controls, bona
fide psychotherapies produce equivalent benefits for patients with PTSD.”
July 14, 2008 at 8:59 am
I have an abstract of a series of reports pertaining to PTSD and the Emotional Freedom Technique, showing data that EFT is very effective in helping personnel with PTSD issues. Please let me know if you would like a copy.
Thanks
July 12, 2009 at 10:02 am
Yes, there are dozens of studies that seem, within themselves, to support the efficacy of certain PTSD treatments. However, what Wampold has done is to perform a meta-analysis on essentially all published studies on treatments for PTSD. When all are thrown into the hopper, what comes out is that no particular therapeutic treatment is any more effective than any other therapeutic treatment. Psychotherapy is effective due to contextual factors (i.e., factors common to all bona fide therapeutic systems)instead of to specific treatments or techniques. This is a rather devastating blow to CBT therapists and others who have tried in recent years to claim a monopoly on effective treatments for PTSD. As Wampold’s research in other areas also confirms, techniques and “Treatments” have little to do with therapeutic effectiveness. Instead, contextual factors are primarily responsible for psychotherapy’s robust effectiveness. This undermines the medical model with it focus on techniques and argues for a new paradigm in clinical psychology that focuses on the personal and interpersonal dimensions of psychotherapy. This is where contemporary scientific research, such as that of Wampold’s, is pointing.
August 23, 2009 at 8:32 am
Recent research, and old hypothesis (Rosenzweig 1936) – the Dodo bird verdict – everybody has won and all shall have prizes.
And yet in my practice, I do not find all approaches equally effective for all problems. This might have to do with my skill (or lack thereof) wtih certain methods, with my comfort level or personal confidence in the method and my abiltiy, as well as the usefulness of that particular approach given the person and their needs.
One thing to bear in mind is that experienced therapists are not stupid or robotic, and we adapt what we do constantly in the presence of a stream of constant feedback from the client. There is the force of almost evolutionary pressure session by session, moment by moment, as variations on interventions are tried, examined, and either reinforced or pruned away. I rarely hear this sort of thing discussed, possibly because many (NOT all) of the people doing the research have little experience of therapy either as therapist or client.