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New Therapy Shows Promise in Treating PTSD and Depression in Veterans

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A new study has demonstrated that a novel therapy, trauma-informed guilt reduction therapy (TrIGR), effectively reduces symptoms of PTSD and depression in veterans by altering their guilt-related cognitions. This significant finding could revolutionise the treatment approach for countless individuals suffering from trauma-related mental health issues.

The study, conducted on 145 post-9/11 US veterans, predominantly male, revealed that the majority were diagnosed with PTSD. TrIGR, a six-session cognitive-behavioural therapy, specifically targets trauma-related guilt and distress, an area that has been relatively unexplored in traditional PTSD treatments.

The findings were published in the Journal of Clinical Psychology.

The effectiveness of TrIGR was measured against supportive care therapy (SCT), a present-centered, non-directive therapy. The results were astonishing: TrIGR not only significantly reduced trauma-related guilt but also had a profound impact on PTSD and depression symptoms. What sets TrIGR apart is its focus on guilt cognitions – the thoughts and beliefs related to one’s role in the traumatic event. The study found that changes in these guilt cognitions, rather than avoidant coping strategies, were the key mediators in reducing PTSD and depression severity.

This focus on guilt cognitions is a departure from the usual emphasis on avoidant coping strategies in PTSD treatments. Avoidant coping, such as substance use or denial, has traditionally been seen as a primary target for therapy. However, the study suggests that while changes in avoidant coping do have some impact, they are less influential than guilt cognitions in long-term symptom reduction.

The study was rigorously designed, with participants randomised into TrIGR or SCT groups and followed up at 3 and 6 months post-treatment. The findings showed that TrIGR’s effects on guilt cognitions were stronger and more consistent than its effects on avoidant coping. This indicates that targeting guilt cognitions might be more beneficial for individuals with trauma-related guilt, which is often a core component of moral injury – the psychological harm that results from actions, or the lack of them, that violate one’s moral or ethical code.

This research has significant implications for the field of mental health, especially for those working with veterans and others who have experienced trauma. TrIGR provides a new avenue for therapists and clinicians to explore, especially for patients who have not responded well to traditional treatments. It suggests that addressing guilt directly could be more effective in treating PTSD and depression symptoms than focusing solely on reducing avoidant coping strategies.

The study also highlights the importance of personalised treatment approaches in mental health. As the effects of trauma vary widely among individuals, treatments that target specific aspects of an individual’s trauma, such as guilt cognitions, could be more effective than one-size-fits-all approaches. This could lead to more tailored therapies that address the unique needs of each individual.

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