Translated article: Exposure or Stabilization: How Do Behavioral Therapists Plan the Outpatient Treatment of Patients with Post-Traumatic Stress Disorder?

<div>Background: According to national and international guidelines,</div><div>trauma-focused treatments such as trauma-focused cognitive-</div><div>behavioral therapies or eye movement desensitization</div><div>and reprocessing (EMDR) are first-choice methods in the treatment</div><div>of patients with post-traumatic stress disorder (PTSD).</div><div>Meta-analyses consistently show highest effect sizes for these</div><div>treatments. This results in clear implications for the treatment</div><div>of patients with PTSD. The present study aimed to assess the</div><div>implementation of a psychological treatment of PTSD patients</div><div>according to the therapy guidelines. Reports to the evaluator</div><div>for the German health-care system in the process of application</div><div>for outpatient psychotherapy are analyzed. Patients and</div><div>Methods: 1,053 reports were analyzed. Finally, 167 reports</div><div>mentioning a traumatic event, the diagnosis of a PTSD, or a</div><div>trauma-focused treatment were included in the study. Results:</div><div>74.3% of the treatment plans were rated as conforming to the</div><div>guidelines (i.e., trauma-focused exposure for patients with</div><div>PTSD diagnosis and no trauma-focused exposure for patients</div><div>without PTSD diagnosis). In 70.3% of the reports to the evaluator</div><div>for patients with PTSD, trauma-focused exposure was described.</div><div>There were no indications that the diagnosis of a PTSD</div><div>was applied too often by established therapists. The overall validity</div><div>of the diagnoses was high. Conclusion: For approximately</div><div>30% of the patients with PTSD, outpatient psychotherapists</div><div>did not mention trauma-focused exposure therapy in their reports,</div><div>i.e. the treatment with the highest clinical evidence was</div><div>not used. Further studies should be made to clarify the reasons</div><div>for this.</div>