Psychological and drug therapies for post-traumatic stress disorder

There is an impressive evidence base for the psychological treatment of post-traumatic stress disorder (PTSD). The strongest evidence is for trauma-focused cognitive therapy and eye movement desensitization and reprocessing (EMDR) but brief eclectic psychotherapy is a promising alternative. As well as this strong evidence for efficacy there is emerging evidence for effectiveness, using these treatments in routine clinical practice without highly trained specialized staff. The treatment of PTSD is more than the use of structured psychotherapy packages – it involves careful assessment and attention to safety, boundary and termination issues. We know much less about how to deal with treatment resistance or complex trauma. Drug treatment is well evaluated with large trials, and has statistical but not clinical efficacy.