Cognitive-behavioral therapy for PTSD in the real world: do interpersonal relationships make a real difference?
The goal of this effectiveness study was to investigate the role of pre-treatment interpersonal relationship functioning in two forms of group cognitive-behavioral treatment (CBT) for veterans with PTSD. Analysis of data from 45 veterans who completed either trauma- or skills-focused CBT indicated no overall differences between the two treatments in PTSD symptomatology, alcohol abuse, or violence perpetration at four months post-treatment. However, there was a stronger inverse relationship between intimate relationship functioning and violence outcomes in the trauma-focused group versus the skills-focused group. While no differences in violence outcomes were found between the treatments at poorer levels of pre-treatment intimate relationship functioning, those receiving trauma-focused treatment with better pre-treatment intimate relationships reported less violence. Extended relationship functioning and violence outcomes were less strongly associated in the trauma-focused group versus the skills-focused group. The theoretical implications of these results, as well as the clinical opportunities to improve CBT for PTSD by capitalizing on patients' relationships, are discussed.
Monson
Candice M
CM
VA National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, USA. candice.monson@med.va.gov
Rodriguez
Benjamin F
BF
Warner
Reid
R
D000328:Adult; D015928:Cognitive Behavioral Therapy; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States; D014728:Veterans