Mervin Smucker – PTSB Treatment

The rational for an algorithmic PTSD model of treatment

Despite the progress in PTSD treatment there are several unanswered questions for clinicians who have to choose the right PTSD invervention.

(1) Shall the clinician always start the PTSD treatment with a confrontation thereapy?

(2) What is to do if the confrontation turns out to be inefficient and contraindicated?

(3) In what case do interventions for cognitive restructuring (CR) make sense in PTSD treatment; which of these interventions are most efficient under which circumstances?

(4) In which case imagery interventions as part of the CR make sense?

(5) When do the CR interventions start in order to finish the exposition, when is to start earlier with the exposition in order to finish the CR?

(6) What is to do if neither the confrontation therapy nor the CR have an effect?

At the moment those questions are considered insufficiently in PTSD literature.

In addition PTSD studies do not yet concerning their study participants sufficiently differentiate between the types of trauma – e.g. between victims of trauma I and trauma II types (Terr, 1991) or between manmade or not manmade traumata.

Furthermore the impact of the victim’s age on the therapy result is not sufficiently considered.

Remarkably there is no research that deals with the issue of trauma-relevant emotions that go beyond fear.

Description of an algorithmic model of treatment

Our preliminary research results show that difficulties in the treatment of PTSD patients indicate by no means an inherent inefficacy of CBT interventions, but are based on the “notmatching” of interventions and the specific trauma features of the patient.

We have developped an algorithmic treatment model supporting clinicians to decide which intervention is the best concerning the special trauma features and its consequences.

Problems in the PTSD treatment shall be mastered With it. The model considers the specific idiosyncratic trauma indications of the victims.