Current Trauma Therapy Research

Trauma therapy research examines the uses and effectiveness of different therapeutic approaches in addressing the effects of trauma, including symptoms of post-traumatic stress disorder (PTSD) and other conditions. These studies focus on the various kinds of trauma-focused psychotherapy, or talk therapy, available for processing memories and emotions related to traumatic events. Here, we’ll share some current research findings on trauma-related therapy techniques including exposure therapy, prolonged exposure therapy, trauma-focused psychotherapy, narrative exposure therapy, written exposure therapy, and present-centered therapy.

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What is trauma?

Traumatic events can be singular, such as a car accident or assault, or ongoing, such as poverty, war, or abuse. 

People respond to trauma in different ways, and what causes trauma-related symptoms for one person may not affect another as deeply. In some cases, witnessing or experiencing trauma can cause a person to develop a trauma-related disorder such as post-traumatic stress disorder (PTSD). 

PTSD symptoms can include:

• Reexperiencing the trauma through recollections, flashbacks, or recurring dreams/nightmares
• Avoidance of people, places, or objects that remind you of the traumatic event
• Disinterest in activities once enjoyed
• Feeling constantly tense or vigilant
• Proneness to anger and/or irritation
• Engaging in risky or self-destructive behaviors
• Having distressing thoughts
• Experiencing physiological signs of stress, such as increased heart rate or sweating
• Reduced emotional responsiveness
• A sense of detachment and estrangement from others
• Chronic physiological arousal, such as being easily startled and experiencing sleep disturbances
• Impaired concentration 
• Difficulty recalling key aspects of the traumatic event
• Finding it difficult to experience positive emotions
• Guilt about surviving the trauma

Treating PTSD and other effects of trauma usually involves some form of talk therapy, sometimes in combination with medication.

Clinical practice guidelines for treating trauma and PTSD

How does a mental health professional know which of the many types of treatment may be best for a client showing signs of PTSD or other trauma-related effects? One resource they may use to make their decision is clinical practice guidelines (CPGs).

CPGs are offered by various organizations, such as the American Psychological Association (APA) and the Department of Veterans Affairs (VA). For example, the APA states that it recommends interventions for clients based on a systematic review of available evidence, "a weighing of the benefits and harms of interventions, consideration of what is known about patient values and preferences, and consideration of the applicability of the evidence across demographic groups and settings." 

In 2021, the APA established a panel to update its 2017 guidelines, which consist of recommendations on psychological and pharmacological treatments for PTSD in adults. These newer guidelines "strongly recommend" the use of cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT), and prolonged exposure therapy (PE) and also suggest the use of brief eclectic psychotherapy (BEP), eye movement desensitization and reprocessing (EMDR), and narrative exposure therapy (NET) in some cases. Below, we’ll take a look at current research for some of these modalities along with a few others.

Current research on exposure therapy (ET) for trauma

A therapeutic component of cognitive behavioral therapy, exposure therapy is aimed at helping people manage the feelings and memories associated with a traumatic event by gradually and safely exposing them to reminders of the experienced trauma. 

This approach, which is used to address anxiety disorders, obsessive-compulsive disorder, and PTSD, may involve in vivo exposure or imaginal exposure. In vivo exposure involves repeatedly confronting trauma-related situations and objects that cause distress but are not dangerous in and of themselves. Imaginal exposure relates to revisiting the distressing memory by recalling it aloud and processing the experience of revisiting the event. 

A 2022 meta-analysis of studies on the topic of exposure therapy for PTSD in particular suggests that it can be effective in comparison to waitlist and treatment-as-usual controls. In the conclusion of the paper, the authors note that their findings on exposure therapy are consistent with the American Psychological Association’s treatment guidelines, which recommend it as a first-line treatment for PTSD. 

Current research on prolonged exposure (PE) therapy for trauma

Prolonged exposure therapy is an exposure-based type of cognitive behavioral therapy developed for PTSD. PE is based on the principle that avoidance of reminders of the trauma may reinforce fear, and by facing these reminders, a person may be able to reduce their PTSD symptoms. PE is based on emotional processing theory and is considered a well‐established treatment approach for PTSD.  

A recent review summarizes the evidence suggesting the efficacy of PE for adults with sexual assault-related PTSD. It concludes by saying that “PE is a very well-established treatment for PTSD that has been studied in a large number of clinical trials.” The review notes that research on new delivery formats for PE—such as telehealth and adaptations for primary care—is currently ongoing.

Current research on trauma-focused psychotherapy

A recent systematic review and clinical analysis of randomized clinical trials examined the impact of trauma-focused psychotherapy (TFT) in relation to interpersonal functioning for people with PTSD. The researchers' findings suggest that "on average, TFPs are moderately efficacious for improving interpersonal functioning." The researchers note, however, that further treatment may be needed to achieve additional improvement. In other words, TFT may be a helpful addition to a treatment plan that also includes other forms of talk therapy.

Current research on narrative exposure therapy for trauma

Narrative exposure therapy (NET) is a short-term treatment for PTSD and trauma disorders, and it may also be appropriate for people who have experienced complex, multiple traumas. NET involves a therapist-guided narrative telling of one's life in an attempt to develop a coherent autobiographical story, allowing for a more nuanced understanding of the traumatic period within the context of one's identity and personal history. 

According to the APA, "it is believed that this contextualizes the network of cognitive, affective, and sensory memories of a patient’s trauma." NET has been most frequently used with refugees and within other communities of people who have experienced trauma stemming from political, cultural, or social factors. 

A 2019 review, meta-analysis, and meta-regression analysis suggests that "sustained treatment results have been reported" from the use of NET. However, the researchers note that the methodological quality of the trials requires further examination, since guideline-supported controlled comparisons with other interventions were lacking. It’s also worth noting that a 2022 mixed-methods study of outpatients with severe mental illness who underwent intensive NET suggests that "this therapy is clearly efficacious in this group."

Current research on written exposure therapy for trauma

Written exposure therapy (WET) is a brief treatment for PTSD in which the client writes about a particular traumatic event they experienced. Afterward, the therapist focuses on the client's experiences in writing about the trauma. A recent systematic review on WET for addressing PTSD symptoms suggests that this therapeutic approach can be an “effective treatment for PTSD symptoms across a variety of samples, settings, and counties." 

Current research on present-centered therapy (PCT) for trauma

Present-centered therapy (PCT) is a short-term treatment approach that focuses on fostering adaptive responses to life stressors and challenges. These stressors or difficulties can be directly or indirectly related to the trauma or PTSD symptoms. Originally developed to compare treatments in trials that evaluated the effectiveness of trauma‐focused CBT, PCT has since been found to be a potential treatment option for PTSD. 

One 2019 review of randomized clinical trials evaluated the effectiveness of PCT for adults with PTSD compared to trauma-focused CBT or a control condition. The review's findings suggest that "PCT does not appear to be as effective as trauma-focused treatments in reducing PTSD severity at post‐treatment." However, the researchers do note that PCT is associated with higher treatment adherence.

Seeking therapy for trauma and PTSD

Many evidence-based therapeutic approaches exist for addressing PTSD symptoms. If you’re interested in exploring a particular approach, you may want to narrow your provider search by looking for a therapist specialized in that modality. If attending in-person therapy is inconvenient or unavailable in your area, you might want to consider online therapy instead. A platform like BetterHelp matches you with a licensed therapist according to your needs and preferences as outlined in a questionnaire, and you can then speak with them remotely from the comfort of home.

A randomized controlled trial evaluated the effectiveness of guided, internet-based, trauma-focused CBT (CBT-TF) versus face-to-face CBT-TF. The trial focused on mild to moderate PTSD in relation to one traumatic event and evaluated 196 adults in mental health settings across the United Kingdom. The trial results led the researchers to suggest that the effects of internet-based CBT-TF for mild to moderate PTSD are comparable to in-person treatment and "should be considered a first-line treatment for people with this condition."