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PTSD Treatment and Couples Therapy Go Hand in Hand

New Study Finds Combined Treatment Effective
By
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 14, 2012 -- For people with posttraumatic stress disorder, going to couples counseling with their partner may ease their PTSD symptoms -- and help their relationship, a new study shows.

The study, published in the Journal of the American Medical Association, used a specialized form of couples therapy called cognitive-based conjoint therapy (CBCT). It showed positive results compared to no therapy at all.

The key may be having your partner there. "PTSD patients don't do as well in individualized therapy," says researcher Candice Monson, PhD, of Ryerson University in Toronto. "Social support emerges as the most robust factor that encourages recovery."

The study included 40 couples, each of which included one partner with PTSD. Half of the couples were put on a wait list for therapy, during which they were allowed to stay on any therapies they were currently undergoing as long as it was not for PTSD. The rest of the couples attended couples therapy once or twice per week, for a total of 15 sessions.

The therapy began with education about PTSD and its potential for harm, as well as strategies to cope with it.

"One of the most important things is giving them an understanding of PTSD so that they don't get the wrong sense of what the disorder is," Monson says.

About PTSD

PTSD is caused by traumatic experiences such as combat, natural disasters, serious car accidents, and sexual assaults. People with PTSD often become emotionally withdrawn or numb. They avoid circumstances and places that remind them of the original trauma. And they are prone to anger and irritability, and are often on edge.

About 5 million U.S. adults have the disorder in any given year. Women are twice as likely as men to experience the disorder at some time in their lives.

In addition to its impact on individuals who have it, PTSD can also harm families. Vietnam veterans with PTSD, for example, have more distressed partners and their children have more behavior problems compared to vets who don't have the disorder.

"PTSD can be very corrosive to a relationship," says UCLA psychologist Shirley Glynn, PhD, who reviewed the study for WebMD. "There's a robust literature that shows that emotional numbness is bad for marital relationships, and irritability and anger can also be corrosive."

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.

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