Meta-Analysis of Counseling Outcomes for the Treatment of Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) results from experiencing, witnessing, or learning about traumatic events that provoke intense fear, helplessness, or horror. The lives of people with PTSD are often disrupted by reoccurring symptoms, intense psychological distress, and avoidance of related stimuli (American Psychiatric Association [APA], 2013). Reoccurring symptoms can include flashbacks, bad dreams, and frightening thoughts, and symptoms may be triggered by words, objects, or situations that remind the victim of the event. The prevalence rate of PTSD around the world is approximately 7.0%, and in the United States, it is approximately 2.0%. Although 2.0% may seem like a small percentage, it means that approximately 6.3 million U.S. citizens have PTSD (Norris & Slone, 2013). PTSD not only is prevalent in adults but also can affect individuals of any age. Giaconia et al. (1995) determined that 14.5% of participants included in their sample of older adolescents who had experienced a serious trauma developed PTSD, and women have a higher probability of developing PTSD than do men (APA, 2013). Most people who experience a traumatic event do not develop PTSD. However, because of the high number of cases seen by counselors and the devastating impact PTSD has on people's lives, it is necessary to compare available treatment approaches and determine treatment efficacy. Counseling is generally the treatment of choice for PTSD (Van Etten & Taylor, 1998). Secondary symptoms of depression or anxiety may co-occur with PTSD, in which case medications may be administered to assist with the feelings of sadness, uneasiness, or worry (Jeffreys, Capehart, & Friedman, 2012). Although medication can help reduce those symptoms, research suggests that medication should be combined with counseling rather than administered alone to treat PTSD (Sharpless & Barber, 2011). Both trauma-focused and non-trauma-focused approaches have been used to treat PTSD. Trauma-focused therapy is an approach that gradually exposes the client to the triggers reminiscent of the traumatic event. Trauma-focused cognitive behavior therapy includes narrative therapy, in vivo exposure, and prolonged exposure therapy. Another highly supported trauma-focused therapy is eye movement desensitization and reprocessing (EMDR). EMDR involves using stimulation to help the brain beneficially reprocess previous psychologically disruptive information. The most common treatment approaches that are not trauma-focused are supportive therapy, interpersonal psychotherapy, meditation, and dialectical behavior therapy (Sharpless & Barber, 2011). Because counseling was the primary treatment approach for clients diagnosed with PTSD, the goal of this meta-analysis was to answer three important questions: (a) Is counseling an effective treatment for individuals with PTSD? (b) Does counseling provide lasting results? and (c) Is there a difference between using trauma-focused therapies and non-trauma-focused therapies in the treatment of individuals with PTSD? * Is Counseling an Effective Treatment for Individuals With PTSD? This meta-analysis predominantly aims to determine if counseling is an effective treatment for clients diagnosed with PTSD. Most researchers preferred counseling as treatment over medication, and numerous clinical trials have produced ample evidence of treatment efficacy. Even though counseling is the treatment of choice, some counseling approaches may be better for treating PTSD than others. Meta-analytic methodology is beneficial because it provides an indication of patterns in study conditions that help to more precisely identify the effects of various methods. During the past 2 decades, approximately six meta-analyses have been conducted on the effects of counseling treatment for clients with PTSD. All focused on various specific treatment methods and demographics, and all produced significant effect sizes. …