Intensive trauma treatment relieves PTSD symptoms within eight days, finds researcher

Relieved from post-traumatic stress disorder symptoms in eight days? It is possible with a highly intensive treatment method that combines trauma-focused therapies and lots of exercise. "About 80% of people no longer have a PTSD diagnosis at the end of the treatment," says Eline Voorendonk, who will receive her Ph.D. on 15 March for her research on this method.

About 80% of people have a traumatic experience at some point in their life. Of these, about 7% develop a post-traumatic stress disorder (PTSD), as a result of, for example, sexual abuse, physical violence, war, or a serious accident. PTSD symptoms, which include reliving the trauma, avoidance behavior, and being overly alert, have a significant impact on daily functioning.

This means that there are thousands of Dutch people with PTSD in need of treatment. Although recognized treatments such as exposure and EMDR therapy are effective, approximately one-quarter of participants stop prematurely, and almost half do not respond well to treatment.

Together with her colleagues, Eline Voorendonk, Ph.D. candidate at Radboud University's Behavioral Science lnstitute and research coordinator at PSYTREC Psychotrauma Expertise Center, sought ways to optimize the treatment of PTSD. She did so by investigating whether it helps to intensify treatment, and by exploring the addition of exercise to the treatment of patients with PTSD.

Intensive program

The resulting intensive trauma-focused treatment combined exposure therapy, EMDR therapy, psychoeducation and physical activity, and was offered within a very short time frame of eight days. "We also wanted to explore the addition of physical activity," says Voorendonk.

"The idea that exercise contributes to mental recovery has become increasingly popular in recent years, also for PTSD. But do people with PTSD benefit from the exercise or from the social support and extra personal attention that comes with it? We therefore compared a group that was offered a lot of moderate-intensity exercise in addition to intensive trauma-focused treatments with a group that was also engaged, but creatively, and therefore stayed at a low heart rate."

Several studies show that the treatment method is highly effective: approximately 80% of people no longer had a PTSD diagnosis after the eight-day treatment. Only 2% to 6% of people dropped out. Surprisingly, this was true both for the group that exercised intensively and the group that engaged in creative activities. "It seems that, within the context of these intensive treatments, the positive effect of exercise on PTSD symptoms is overestimated," says Voorendonk.

This is not to say that exercise is not important, she says. PTSD is often associated with physical health problems, and exercise contributes to physical health. "We may need to zoom in further on the influence of exercise on PTSD. Think about the optimal intensity, duration and sequence of exercise: how does it work and what works for whom?" For example, a study by Voorendonk and her colleagues showed that exercise after an exposure session caused a stronger decrease in symptoms compared to exercise prior to an exposure session.

Long term

The positive outcome of the intensive treatment also appears to persist in the longer term—at least six months—with only limited relapse. Moreover, the treatment appears to be suitable for people with Complex PTSD (CPTSD), a severe form of PTSD in which the patient suffers from additional symptoms.

"It is thought that these symptoms get in the way of the trauma-focused treatment, so another treatment is often recommended that first focuses on stabilization. The study we conducted with more than 200 people with CPTSD shows that they respond equally well to intensive trauma-focused treatment. Starting straight away can avoid unnecessary delays," says Voorendonk.