PTSD Treatment Options
Evidence-based treatments for PTSD, including trauma-focused psychotherapies and FDA-approved medications. Learn how each treatment works and what to expect.
✅ Good News: PTSD Is Treatable
Research shows that 53-80% of people who complete evidence-based trauma therapy no longer meet criteria for PTSD. Treatment works, and recovery is possible.
First-Line Treatments
The following trauma-focused psychotherapies are strongly recommended by the VA/DoD, American Psychological Association, and international guidelines as first-line treatments for PTSD.
Cognitive Processing Therapy (CPT)
CPT helps you understand and change unhelpful beliefs you developed after trauma. You'll learn to examine thoughts like "It was my fault" or "I can't trust anyone" and develop more balanced perspectives.
What to expect:
- Learn about PTSD and how thoughts affect feelings
- Write an impact statement about how trauma affected your beliefs
- Use worksheets to identify and challenge "stuck points"
- Develop new, more balanced ways of thinking
- Write a final impact statement showing changed beliefs
Prolonged Exposure (PE)
PE helps you gradually approach trauma-related memories and situations you've been avoiding. By facing rather than avoiding, you learn that memories aren't dangerous and anxiety decreases naturally.
What to expect:
- Learn about PTSD and how avoidance maintains it
- Practice breathing techniques for anxiety management
- In-vivo exposure: Gradually approach avoided situations in real life
- Imaginal exposure: Recount the trauma memory repeatedly in session
- Listen to session recordings at home for processing
EMDR (Eye Movement Desensitization and Reprocessing)
EMDR uses bilateral stimulation (like side-to-side eye movements) while you briefly focus on traumatic memories. This helps your brain reprocess trauma so it becomes less distressing.
What to expect:
- History-taking and treatment planning
- Learn coping techniques for emotional distress
- Identify target memories, negative beliefs, and desired beliefs
- Process memories with bilateral stimulation (eye movements, taps, or tones)
- Install positive beliefs and check for remaining distress
Treatment Comparison
| Treatment | Sessions | Approach | Best For |
|---|---|---|---|
| CPT | 12 | Cognitive (changing thoughts) | Those who prefer to work with thoughts; guilt/shame prominent |
| PE | 8-15 | Behavioral (facing fears) | High avoidance; willing to approach feared situations |
| EMDR | 6-12 | Memory reprocessing | Those uncomfortable with extensive talking about trauma |
All three treatments are equally effective. The "best" treatment is the one you'll complete. Discuss with your therapist to find the best fit.
Medications for PTSD
While trauma-focused therapy is first-line treatment, medications can help reduce symptoms, especially when combined with therapy or when therapy isn't immediately available.
FDA-Approved for PTSD
- Sertraline (Zoloft) — SSRI; 50-200mg daily. Can reduce all symptom clusters.
- Paroxetine (Paxil) — SSRI; 20-60mg daily. Effective for core PTSD symptoms.
Other Evidence-Based Options
- Venlafaxine (Effexor XR) — SNRI with evidence supporting use for PTSD.
- Prazosin — Alpha-blocker used for PTSD-related nightmares (off-label).
⚠️ Medications to Avoid
Benzodiazepines (Xanax, Klonopin, Ativan) are NOT recommended for PTSD. Research shows they can worsen outcomes, interfere with trauma processing, and carry significant addiction risk. If you're currently taking benzodiazepines, talk to your prescriber about tapering safely—don't stop abruptly.
What If Therapy Feels Too Hard?
It's common to feel apprehensive about trauma-focused therapy. Here's what to know:
- Temporary increase in distress is normal — Symptoms may briefly worsen as you process trauma, but this typically resolves
- You control the pace — A good therapist will work at a pace you can handle
- Avoidance is understandable but keeps you stuck — Facing trauma in therapy, while hard, leads to relief
- Dropout is common but completers do well — Those who complete therapy have excellent outcomes
💡 Skills-Based Stabilization First?
Some people benefit from skills-based therapy before trauma-focused work. Approaches like Seeking Safety or Skills Training in Affective and Interpersonal Regulation (STAIR) can help with emotion regulation and coping. Discuss with your provider what approach makes sense for you.
Finding a Trained Therapist
Not all therapists are trained in evidence-based PTSD treatments. Here's how to find the right one:
- Ask about specific training: "Are you trained in CPT, PE, or EMDR?"
- Check credentials: Licensed psychologist, clinical social worker, or counselor
- VA resources: Veterans can access free PTSD treatment through the VA (1-877-222-8387)
- Psychology Today directory: Filter by PTSD specialty
- EMDR International Association: Therapist directory at emdria.org
- CPT Therapist Directory: cptforptsd.com