Evidence-Based Psychotherapy

There are a few psychotherapies with evidence for reducing PTSD. Only three are strongly recommended according to evidence-based treatment guidelines:

  • Prolonged Exposure (PE)
  • Cognitive Processing Therapy (CPT)
  • Eye Movement Desensitization and Reprocessing (EMDR)

If you are struggling with symptoms of PTSD, you need one of these treatments.

Prolonged Exposure is a very effective treatment for PTSD, and is my personal treatment of choice. PE involves revisiting the traumatic experience in a safe and supportive environment so that you can finally emotionally process the trauma. This revisiting happens in a therapeutic manner designed to help you heal. Conversations including discussing your perspectives about the trauma and considering new meaning that comes through revisiting the memory. Over time, when the trauma is processed enough, the memories don’t “burn to the touch” as much, so to speak. That can often lead to profound shifts in the way you feel on a day-to-day basis. PE usually takes 10-16 sessions or so.

Cognitive Processing Therapy is another evidence-based treatment for PTSD. CPT focuses much more on your thinking about the trauma. Through CPT, you will primarily discuss the meaning you have taken from the traumatic experience. Your therapist will help you think through different “stuck points” in your thinking about the event(s). Then, they will teach you skills to help you think through these “stuck points” on your own in the future. CPT generally takes around 12 sessions.

Eye Movement Desensitization and Reprocessing is evidence-based for PTSD, is extremely popular among therapists in many communities, and is highly controversial among trauma researchers. This treatment involves revisiting the traumatic memory while engaging in back-and-forth eye movements. It may involve another form of bilateral stimulation (such as an alternating buzzer in each hand).

Also, lots of people are doing EMDR who aren’t well-trained in PTSD more generally. Its explosion in popularity has made it hard to know if you’re actually getting good care. EMDR should also only take around 6-12 sessions. Many therapists will “weave EMDR in” to a much longer course of treatment, which is not usually necessary. That said, EMDR should work – and it’s usually fairly easy to find a therapist trained in it!

https://www.anxietytraumaclinic.com/post/ptsd-series-evidence-based-psychotherapy

Child Affected by Parental Relationship Distress

A new condition, “child affected by parental relationship distress” (CAPRD), was introduced in the DSM-5. A relational problem, CAPRD is defined in the chapter of theDSM-5 under “Other Conditions That May Be a Focus of Clinical Attention.” The purpose of this article is to explain the usefulness of this new terminology.

Method

A brief review of the literature establishing that children are affected by parental relationship distress is presented. In order to elaborate on the clinical presentations of CAPRD, four common scenarios are described in more detail: children may react to parental intimate partner distress; to parental intimate partner violence; to acrimonious divorce; and to unfair disparagement of one parent by another. Reactions of the child may include onset or exacerbation of psychological symptoms, somatic complaints, an internal loyalty conflict, and, in the extreme, parental alienation, leading to loss of a parent–child relationship.

Results

Since the definition of CAPRD in the DSM-5 consists of only one sentence, the authors propose an expanded explanation, clarifying that children may develop behavioral, cognitive, affective, and physical symptoms when they experience varying degrees of parental relationship distress, i.e., intimate partner distress and intimate partner violence, which are defined with more specificity and reliability in the DSM-5.

Conclusion

CAPRD, like other relational problems, provides a way to define key relationship patterns that appear to lead to or exacerbate adverse mental health outcomes. It deserves the attention of clinicians who work with youth, as well as researchers assessing environmental inputs to common mental health problems.

Child Affected by Parental Relationship Distress

PAS & THE DSM

According to the literature, Parental Alienation, like narcissism is well recog-
nized within the mental health field and among many experienced profes-
sionals, Parental Alienation Syndrome (PAS) is accepted as well. The DSM-IV

does not currently include PAS because the term was introduced as the DSM-
IV was being written for publication. It takes years of data before it can be

introduced, considered and accepted. A syndrome is a pattern or cluster of

symptoms indicative of some disease.

At this point, DSM-V is scheduled for publication around 2011 and it

appears promising that it will acknowledge PAS because of the extensive

professional literature and clinical findings now available. DSM requirements

420 D. M. Summers & C. C. Summers

are quite stringent, and justifiably so. In his article, “Denial of the Parental

Alienation Syndrome, Also Harms Women,” Richard Gardner explains why

PAS has not made the pages of the DSM-IV at this time.

Gille de la Tourette first described his syndrome in 1885. It was not until

1980, 95 years later, that the disorder found its way into the DSM. It is im-
portant to note that at that point, ‘Tourette’s Syndrome’ became ‘Tourette’s

Disorder.’ Asperger first described his syndrome in 1957. It was not until

1994 (37 years later) that it was accepted into DSM-IV and ‘Asperger’s Syn-
drome’ became ‘Asperger’s Disorder.’ . . . DSM-IV states specifically that all

disorders contained in the volume are syndromes, and they would not be

there if they were not syndromes . . . Once accepted, the name syndrome

becomes changed to disorder. However; this is not automatically the pat-
tern for non-psychiatric disorders . . . Often the term syndrome becomes

locked into the name and becomes so well known that changing the

word syndrome to disorder may seem awkward. For example, Down’s

syndrome, although well recognized, has never become Down’s disorder.

Similarly, AIDS (Autoimmune Deficiency Syndrome) is a well-recognized

disease, but still retains the syndrome term. (Gardner, 2002a, pp. 191–202)

https://drive.google.com/file/d/0BypP5tNaxQHWZmFmZGYyY2UtYjg4My00YWE4LTgwZDktNDQ1ZGZlZDk5YzI4/view

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