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A guided imagery fan sees a report on WebMD that states only exposure therapy is effective for postt

08 Nov
A guided imagery fan sees a report on WebMD that states only exposure therapy is effective for posttraumatic stress, and wants to know if BR’s work was included in the meta-analysis...
Dear Belleruth,
On WebMD today (11/2/07), they cite a study that evaluates various therapies for the treatment of posttraumatic stress (PTSD). The gist of it is that the study said there is a lack of good and effective therapies for PTSD. Was your work even evaluated?
If not, why not?
They went on to say EXPOSURE therapy was effective. Check it out! Whassup with that??
Susan



Dear Susan,
Thanks for the query. Yes, I’m aware of this review of treatments for posttraumatic stress, and of its conclusion that Prolonged Exposure Therapy (sometimes referred to as Cognitive-Behavioral Therapy or CBT) is the only proven intervention of merit for PTSD.

Actually, prolonged exposure is effective for a majority of those who stick with it, but it does have a fairly high drop-out rate, because of the flooding and distress it often produces at the outset. EMDR is a method that has gotten good results as well, and, because of the distracting elements in its protocol, seems to produce less distress. EMDR probably should have been mentioned in that review as well, as it has been studied quite a bit and often in favorable comparison to CBT. Both methods, it should be noted, are imagery-based, using imagery at the core of their procedures. I describe both and other effective methods like them in Invisible Heroes. If you take a look at this week’s Hot Research, you’ll see a more even-handed meta-analysis of these methods and more.

My guided imagery work was not evaluated for this, because the Duke/Durham V.A. studies are recent and still in process - one was small and just completed and another is only a bit more than halfway done. When these outcomes are published in a refereed journal, guided imagery will qualify for inclusion. (the outcomes in both studies are entirely comparable to the outcomes from exposure therapy, yet require far less professional time and expense). I very much look forward to reading Dr. Jennifer Strauss’ articles when her final measures are collected and analyzed. It’s frustrating to know that there is an effective intervention available for our soldiers and vets that is inexpensive, accessible, feasible, portable and downloadable, but it’s not getting to most of them yet.

Thanks for the question! Check back in 6 months!

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award