IS THERE A WAY FOR DIFFERENT TREATMENTS TO WORK TOGETHER TO SUCCESSFULLY TREAT PTSD?

I was recently reading about research into ways to lower stress in adults with long-term PTSD (post traumatic stress disorder) Markowitz, et al. Is exposure necessary? A randomized clinical trial of interpersonal psychotherapy (IPT) for PTSD. Am J Psychiatry 2015 Feb 13; (e-pub).  The study compared IPT to exposure therapy (ET) to relaxation therapy (RT).  They studied 110 unmedicated adults with long-term PTSD who were not receiving psychiatric treatment.  These adults received 14 weeks of IPT (focusing on the emotional and interpersonal impact of their traumas), or 14 weeks of ET, or 14 weeks of RT.  Results indicated a greater but not statistically significant symptom reduction with ET, but the over all response rate was 63% for IPT, 47% for ET, and 38% for RT.

What excites me about these results is that three different types of treatments were helpful in reducing PTSD symptoms.  It makes me think about a continuum from an initial focus on relaxation techniques and then exposure therapy followed by interpersonal therapy.  The relaxation skills could help people pace their treatments so that they do not experience retraumatization. I also wonder if IPT might need to be used before ET or intermittently after ET has begun.  It does seem that it is important to identify the traumatic experiences and then be able to purposefully think about them without re-experiencing the stress connected to them. Being able to do this successfully would seem to be more likely if people with PTSD had access to all three of these treatments as well as pharmacotherapy.