Conventional and Unconventional Treatment Methods of PTSD:

Which is Better at Decreasing Symptoms of PTSD?

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CONVENTIONAL AND UNCONVENTIONAL TREATMENTS 2

Conventional and Unconventional Treatment Methods of PTSD: Which is Better at

Decreasing Symptoms of PTSD?

Post-traumatic stress disorder (PTSD) is a mental health disorder that is typically

followed after one has experienced or directly witness a traumatic event (Mayo Clinic, 2018).

Symptoms of PTSD may be present a month after the event or sometimes may even take longer

to appear, it is vital that one seeks help to treat and reduce these symptoms of PTSD as they can

and will impede on one’s day-to-day functioning (Mayo Clinic, 2018). Symptoms of PTSD

include but are not limited to, having flashbacks of the traumatic event, avoiding any stimuli

(people, places or things) that remind one of the event, feelings of hopelessness towards the self,

and detachment from the real world and being in a constant state of arousal (Mayo Clinic, 2018).

Every person is susceptible to developing symptoms of PTSD, however, many of those

who have served in the military have been diagnosed with PTSD (National Veterans Foundation,

2015; U.S. Department of Veterans Affairs, 2018). According to the U.S. Department of

Veterans Affairs (2018), about 30% of Vietnam veterans have been diagnosed with PTSD in

their lifetime. The cause of their diagnoses are a result of combat or missions that expose them to

horrific and life-threatening events (U.S. Department of Veterans Affairs, 2018).

Having symptoms of PTSD as a result of fighting wars, being in battle and/or

experiencing life in deployment can take a serious toll on the veteran. It is imperative that

veterans be given and seek out treatments for their symptoms of PTSD. However, what kinds of

treatments should veterans choose to receive? With the abundance of treatment methods to

choose from, it is important to determine which is most effective in treating symptoms of PTSD

in the future. This paper will explore specifically whether conventional treatment methods are

better than unconventional treatment methods to treat for PTSD symptoms. Treatment methods

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like cognitive-behavior therapy and exposure therapy, or cognitive-exposure therapy will be

considered conventional treatment methods as these forms of treatment of PTSD have been used

for a long time by mental health practitioners. On the contrary, unconventional treatment

methods include using the internet to conduct therapy sessions, virtual reality (VR) simulations

and even creative arts to help treat PTSD symptoms.

Literature Review

Treatment Types for PTSD

Tarrier, Liversidge & Gregg (2006) list and analyzed the effectiveness of the different types

of psychological treatments available for PTSD; their list ranged from highly researched and

common types treatment methods to those that are fairly newly developed forms of treatment for

PTSD. Among the treatments available, cognitive-behavioral treatments have been shown to be

the most effective in treating symptoms of PTSD (Bryant, & Tarrier, 2003; Tarrier, Liversidge &

Gregg, 2006). Tarrier, Liversidge & Gregg (2006) also highlighted that treatment methods focused

on re-exposing the client to the trauma while also involving the analysis of thought processes that

have been altered by the trauma be a more beneficial form of treatment. Tarrier, Liversidge &

Gregg (2006), mentioned the fact that some new forms of treatment like VR simulation (to

reassemble the traumatic event) and using software programs and the internet to administer therapy

have not been well researched. Research done by Tarrier, Liversidge & Gregg (2006), testing each

form of treatment surveying patients show that cognitive based forms of therapy are usually

preferred over any other methods of treating PTSD. While new forms of treatment including VR,

computer-based treatments and using the internet to conduct therapy (e-therapy) were not highly

rated and recommended by patients.

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Pomerantz (2017) talked about the two main psychotherapy treatments of PTSD, which

included cognitive processing therapy (CPT) and prolonged exposure (PE) being the most

common treatment methods provided to veterans diagnosed with PTSD. Pomerantz (2017)

highlighted that both CPT and PE have been a first-choice treatment method by the Veterans

Health Administration (VA) and the Department of Defense (DoD) to treat PTSD. Though CPT

and PE are more commonly offered as a first choice, many veterans were not keen in participating

in these types of treatments because of the stigma and having to keep up with the weekly

appointments (Pomerantz, 2017). Besides being able to treat PTSD, both CPT and PE have been

shown to be able to help veterans who suffered from smaller levels (symptoms) of PTSD – did not

meet the criteria to be diagnosed for PTSD (Pomerantz, 2017). Though CPT and PE do not

guarantee successful reduction and disappearance of PTSD symptoms, CPT and PE have been

shown to be an important factor for patients to be able to receive more intense forms of treatments

and allow for more patients to be more willing to receive treatment (Pomerantz, 2017).

Hobfoll, Blais, Stevens, Walt & Gengler (2016) published a paper that talked about using

an online cognitive-behavioral therapy intervention to help treat veterans’ PTSD symptoms. The

study looked at the online web-based program called ‘Vets Prevail’ that is a form of intervention

for veterans who have come back from deployment on the internet that allows the user to be able

to interact with the online tool but also interact with real life users (Hobfoll et al., 2016). This web-

based intervention aimed to help veterans by delivering CBT treatments through seven sessions –

besides lessons posted, this web-based program also allowed for veterans to contact other veterans

who experienced PTSD symptoms (Hobfoll et al., 2016). These lessons were done at the patient’s

own pace whenever they wanted and that helped the patient understand how their thoughts and

feelings could affect their day-to-day functioning (Hobfoll et al., 2016). Hobfoll et al. (2016)

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showed that veterans who participated in their study and used Vets Prevail had shown a significant

lowering of their symptoms of PTSD. Hobfoll et al. (2016) also highlight that the treatment had

also been effective in removing barriers that existed so that more veterans are able to receive

treatment for their symptoms. Vets Prevail could be a first step intervention used to help alleviate

first signs of PTSD in veterans so that symptoms are not prolonged and dragged out (Hobfoll et

al., 2016).

Baker, Metcalf, Tracey & O’Donnell (2018) reviewed different types of creative arts

therapy methods in helping to treat PTSD. Baker et al. (2018) first summarized a study done on

using music therapy to treat PTSD, which entailed an improvisation of music instruments and a

reflection of the experience with and without contact with a therapist. The study concluded that

both music therapies conducted with and without contact with a therapy had very low impact in

treating symptoms of PTSD (Baker et al., 2018). The next form of creative arts therapy studied by

Baker et al. (2018) was art therapy treatment which had patients making different types of art with

and without contact with a therapist (Baker et al., 2018). Baker et al. (2018) found that art therapy

had shown a significant reduction of PTSD among participants in this group. Baker et al. (2018)

also found that drama therapy, showed not effect in helping reduce symptoms of PTSD. Overall,

the evidence showed very low effectiveness of the treatment of PTSD using creative arts therapies,

however creative arts therapy does provide those diagnosed with PTSD another alternative

treatment to PTSD (Baker et al., 2018).

Counterargument

Much of the empirical evidence above does show more support to the conventional

treatment methods of PTSD. However, one piece of evidence does point to unconventional

treatment methods being an effective route of treatment of PTSD. According to Hobfoll et al.

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(2016), it would seem as if web-based types of treatments are quite effective in treating

symptoms of PTSD. Hobfoll et al. (2016) conducted a study using a web-based program called

Vets Prevail to see how effective the program would be in treating PTSD in veterans. This

program used media lessons as well as community posts (so veterans would be able to interact

with each other if they wanted to) to help deliver the principles of CBT – veterans would be able

to receive the most effective treatment of PTSD but at their own time and in the comfort of their

own homes if they used Vets Prevail (Hobfoll et al., 2016). Though Vets Prevail does provide

CBT, it is unconventional because this treatment is still being provided through the internet and

not face-to-face.

Pomerantz (2017) highlights that many veterans do not wish to seek out conventional

methods of treatment like (CPT or PE) because of the stigma surrounding the treatment of PTSD.

Using unconventional treatment methods like Vets Prevail helps lessen the stigma around getting

psychological help because this is not a traditional form of receiving mental health treatment

(Hobfoll et al., 2016). Using Vets Prevail, veterans would complete this through a computer.

Because the measure would be a web-based program, the veterans would be able to stay

anonymous and still interact with others, especially with a therapist, as this program was also

developed with the help of mental health practitioners. Veterans would not face the

embarrassment of seeking or receiving treatment because they would use Vets Prevail in the

comfort of their own home and remain anonymous so people would not be able to trace it back to

them. Besides that, having Vets Prevail used a common method of treating PTSD would help

reach a variety of patients especially those who live further away in the suburbs and prevent

them from getting the best care (Hobfoll et al., 2016).

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Discussion

According to the article published by Tarrier, Liversidge & Gregg (2006) a majority of

people would much rather undergo conventional forms of treatment, which include having to see

a therapist in order to receive CBT. Using technology like VR to simulate the traumatic event, or

even using the internet to provide the same form of treatment were not preferred by veterans to

help symptoms of PTSD. Out of all the treatments available, veterans still preferred using CBT

and also using exposure therapy to help them start the healing process, though be re-exposed to

the trauma may cause more stress (Tarrier, Liversidge & Gregg, 2006). Tarrier, Liversidge &

Gregg (2006) make very valid statements about the effectiveness of conventional treatments like

CBT and ET, and also point out what forms and types of treatments are accepted by veterans to

help treat their PTSD.

Pomerantz (2017) also backed up the effectiveness of CBT treatments and PE treatment,

with Pomerantz highlighting that CPT showed to be a very common treatment method of PTSD.

According to the American Psychological Association (2017), CPT is a type of CBT that aims to

help the patient to change any beliefs of the trauma that are obstructive. It was said that CPT

specifically is a very effective form of treatment of PTSD as both the Department of Defense and

Veterans Health Administration both choose CPT (and PE) as their preferred form of treatment

in military personnel – both active and inactive.

Baker et al. (2018) provide support that unconventional methods of treatment do not do a

good job in helping to reduce symptoms and successfully treat PTSD. All the different studies

conducted for the different creative arts therapies showed very low support in reducing the

symptoms, and so therefore would not be very effective in treating veterans’ PTSD. Though Vets

Prevail is an unconventional treatment method, being an internet-based therapy platform, it is

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interesting to note that it is effective in helping treat veterans’ symptoms of PTSD and its success

could be the fact that the type of treatment used is cognitive behavioral based.

Conclusion

In conclusion, conventional treatment methods should be used and sought after as the

first form of treatment for PTSD in veterans, when compared to the option of unconventional

treatment methods. Most importantly CBT treatment methods like CPT should be used to help

treat PTSD in veterans (Pomerantz, 2017; Tarrier, Liversidge & Gregg, 2006). CBT should be

used because they are highly effective in helping to reduce the symptoms of CBT in veterans

(Pomerantz, 2017; Tarrier, Liversidge & Gregg, 2006). Many people would much rather choose

conventional treatment methods (like CBT and PE to name a few) over unconventional treatment

methods to help treat their PTSD (Tarrier, Liversidge & Gregg, 2006). Many people/groups like

the Department of Defense and Veterans Health Affairs choose conventional treatment methods

to help effectively treat PTSD (Pomerantz, 2017). Overall it is important that those diagnosed

with PTSD take action and treat their PTSD, but that they choose treatments that actually are

proven to be effective such as conventional treatment methods like CBT.

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References

American Psychological Association. (2017). Cognitive processing therapy (CPT). American

Psychological Association. Retrieved from https://www.apa.org/ptsd-

guideline/treatments/cognitive-processing-therapy

Baker, F. A., Metcalf, O., Varker, T. & O’Donnell, M. (2018). A systematic review of the

efficacy of creative arts therapies in the treatment of adults with PTSD. Psychological

Trauma: Theory, Research, Practice, and Policy,10(6), 643-651.

http://dx.doi.org/10.1037/tra0000353

Hobfoll, S. E., Blais, R. K., Stevens, N. R., Walt, L., & Gengler, R. (2016). Vets prevail online

intervention reduces PTSD and depression in veterans with mild-to-moderate symptoms.

Journal of Consulting and Clinical Psychology, 84(1), 31–42.

http://dx.doi.org/10.1037/ccp0000041

Mayo Clinic. (2018). Post-traumatic stress disorder (PTSD). Mayo Clinic. Retrieved from

https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-

disorder/symptoms-causes/syc-20355967

National Veterans Foundation. (2015). The far-reaching effects of PTSD in Veterans. National

Veterans Foundation. Retrieved from https://nvf.org/effects-of-ptsd-in-veterans/

Pomerantz, A. S. (2017). Treating PTSD in primary care: One small step is one giant leap.

Families, Systems, & Health, 35(4), 505-507. http://dx.doi.org/10.1037/fsh0000318

Tarrier, N., Liversidge, T. & Gregg, L. (2006). The acceptability and preference for the

psychological treatment of PTSD. Behavior Research and Therapy, 44, 1643-1656.

doi:10.1016/j.brat.2005.11.012

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http://dx.doi.org/10.1037/fsh0000318
CONVENTIONAL AND UNCONVENTIONAL TREATMENTS 10

U.S. Department of Veterans Affairs. (2018). How common is PTSD in veterans? U.S.

Department of Veterans Affairs. Retrieved from

https://www.ptsd.va.gov/understand/common/common_veterans.asp

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https://www.ptsd.va.gov/understand/common/common_veterans.asp
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