PTSD Treatment and Couples Therapy Go Hand in Hand
New Study Finds Combined Treatment Effective
Partners of People With PTSD
During the second phase of the therapy, couples learn how to switch from avoidance to approach. That is, with the help of the therapist, they drafted a list of things they have actively shied away from because of the disorder -- social gatherings, for example -- and then begin to integrate the items on their list back into their lives.
Monson says partners of people with PTSD often have the best intentions but can inadvertently maintain the disorder by agreeing to avoid situations that may cause discomfort.
"By agreeing not to go to family gatherings or out to dinner, for example, because her husband is too anxious, the wife simply reinforces the idea that the symptoms can't be managed," Monson says. "They shrink their lives to manage the anxiety ... We help them reexamine such unhelpful thoughts and behaviors."
The last phase of the therapy focuses on the problematic beliefs that each partner holds and that contributes to PTSD and their relationship problems. They address issues of trust, control, emotional closeness, and physical intimacy.
At the end of the study period, the couples that had gotten therapy showed significant improvements. Their satisfaction with their relationship increased more than four times as much as the couples who were not treated.
Meanwhile, the partners with PTSD reported an average 50% reduction in the severity of their symptoms, or about three times the improvement of those on the wait list. More than three quarters of them no longer met the criteria for PTSD.
The study shows that this therapeutic approach was better than no therapy -- but it doesn't show whether the therapy the researchers have developed is more or less effective than other types of therapy.
Also, an editorial published with the study points out that the people in Monson's study seemed "easier to treat" than couples who face similar problems. In general, writes editorial author Lisa M. Najavits, PhD, these couples were in highly stable and satisfying relationships, without accompanying issues such as alcoholism, drug addiction, or abusive behavior.
"Thus, the trial by Monson et al cannot be interpreted as being applicable to couples with these additional challenges, which may be the couples in greatest need of help," writes Najavits, a psychologist at the Veterans Affairs Boston Healthcare System.