A randomized controlled trial published in the current issue of Psychotherapy and Psychosomatics sheds new therapeutic opportunities for overcoming trauma. Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioral backgrounds, such as gestalt therapy. The Authors tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioral treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates.
141 treatment-seeking individuals with a diagnosis of PTSD were randomized to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Results showed that patients in both conditions achieved significant and large reductions in PTSD symptoms which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Dropout rates were similar in both conditions respectively 12.2% in DET and 14.9% in CPT.
Overall, results indicate that DET merits further research and may be an alternative to established treatments for PTSD. Authors also stressed that further research needs to evaluate whether DET confers advantages in areas of functioning beyond PTSD symptoms.