Would regular therapy sessions every 1-2 months be helpful in preventing Post-Traumatic Stress Disorder (PTSD) relapse?

From the Guidelines

Therapy sessions every 1-2 months are likely insufficient for preventing PTSD relapse, and more frequent sessions, typically weekly or biweekly, are generally recommended during active treatment. For effective PTSD relapse prevention, a combination of regular therapy (using evidence-based approaches like Cognitive Processing Therapy or Prolonged Exposure), medication if prescribed (such as SSRIs like sertraline 50-200mg daily or paroxetine 20-60mg daily), and self-management techniques is optimal 1. The most recent guidelines recommend use of specific manualized psychotherapies over pharmacotherapy, with prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy being preferred options 1.

Some key points to consider in PTSD management include:

• Regular therapy sessions to reinforce coping skills and process traumatic memories
• Medication, if prescribed, to help manage symptoms
• Self-management techniques, such as practicing skills learned in therapy, using grounding techniques during triggers, maintaining a symptom journal, and having a crisis plan
• Gradually decreasing session frequency as symptoms improve, but having a plan to quickly increase session frequency during periods of increased symptoms

It's also important to note that the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline recommends against use of benzodiazepines, cannabis, or cannabis-derived products for PTSD treatment 1. Overall, a comprehensive approach that incorporates evidence-based therapies, medication, and self-management techniques is crucial for preventing PTSD relapse and improving quality of life.

From the Research

Therapy Sessions for Preventing PTSD Relapse

• The effectiveness of therapy sessions every 1-2 months for preventing PTSD relapse is not directly addressed in the provided studies.
• However, studies suggest that psychological treatments, such as cognitive behavioral therapy with a trauma focus (CBT-TF), cognitive processing therapy (CPT), cognitive therapy (CT), eye movement desensitisation and reprocessing (EMDR), and prolonged exposure (PE), are effective in treating PTSD 2.
• Regular therapy sessions may be beneficial in maintaining treatment gains and preventing relapse, but the optimal frequency of sessions is not specified in the studies.
• A study on the prevention of PTSD found that brief trauma-focused cognitive behavioral therapy was more effective than supportive counseling in reducing PTSD symptom severity, but the study did not examine the effect of session frequency 3.

Factors Influencing Treatment Response

• Factors such as symptom severity, childhood sexual trauma, and sexual assault as index trauma can influence treatment response to SSRIs in patients with PTSD 4.
• The study suggests that patients with longer time since index trauma might particularly benefit from treatment with sertraline or paroxetine.
• However, the study does not provide information on the optimal frequency of therapy sessions for preventing relapse.

Limitations of Current Evidence

• The current evidence base for PTSD treatment is limited, and more research is needed to identify the most effective treatments and treatment schedules 2, 5, 3.
• The studies provided do not directly address the question of whether therapy sessions every 1-2 months are helpful in preventing PTSD relapse.
• Further research is needed to determine the optimal frequency and duration of therapy sessions for maintaining treatment gains and preventing relapse in patients with PTSD.