Trauma may happen to everyone, and some people who experience trauma (5.6%) are diagnosed with Post-Traumatic Stress Disorder (PTSD). Trauma often affects every area of daily life, including but not limited to relationships, parenting, work productivity etc.
Several psychological therapies can treat PTSD in adults, such as Eye movement desensitization reprocessing (EMDR) and trauma-focused cognitive behavioural therapy (TF-CBT). However, there are still many PTSD sufferers who do not seek professional help due to several factors, one of which is cost.
A recent study published in 2020 in the UK examined the relationship between costs and years of life and quality-adjusted life-years (QALYs). They compared the following intervention groups in their economic analysis.
- TF-CBT includes cognitive therapy, exposure/extended exposure therapy, virtual reality exposure therapy, mindfulness-based cognitive therapy, and narrative exposure therapy.
- Non-TF-CBT focuses on the current symptoms of PTSD without revisiting the trauma experience.
- Combined somatic/cognitive therapies, such as emotional freedom techniques and thought field therapy, are exposure-based treatments with cognitive and somatic components that utilize tapping points on the body.
- EMDR treats dysfunctional intrusions, emotions, and physical sensations experienced by trauma victims by integrating the targeted event as an adaptive contextualized memory.
- Counselling: helping clients to focus on their thoughts, feelings, and behaviours; achieve a clearer self-understanding; and discover and use their strengths to cope more effectively with their lives by making the right decisions or taking relevant actions.
- Psychoeducation is mainly educational and involves providing information about the nature and causes of PTSD and strategies and treatments that can help address PTSD symptoms.
- Self-help therapy with and without support: includes Internet-based TF-CBT or psychological treatment, expressive writing and cognitive bibliotherapy. Self-help with help includes interventions in which the therapist’s input is an integral part of the intervention; in self-help without support, the therapist’s input is minimal or absent.
- Medication: selective serotonin reuptake inhibitors (SSRIs)
- Combined TF-CBT/SSRI
- No treatment, reflected in a waitlist
The duration of therapy considered was three months (12 weeks). This model is determined based on the average treatment time and routine clinical practice (4-20 weeks). After carrying out therapy for a predetermined period, the validity of the client’s PTSD diagnosis was assessed. The group declared no PTSD status was still being evaluated for three months, whether they relapsed or died.
EMDR is the most cost-effective intervention for adults with PTSD
The study concludes that EMDR is the most cost-effective intervention for adults with PTSD more than three months after trauma, followed by a combination of somatic/cognitive therapy, self-help with support, psychoeducation, SSRI, TF-CBT, self-help without support, non-TF-CBT and TF-CBT/SSRI combination. Counselling appeared less cost-effective than no treatment due to its relatively low clinical effectiveness (the weakest among all active treatments assessed in the economic analysis).
If you want to learn more about EMDR, book a free 20 mins EMDR intensive session with Dr Julia Andre.