Comparing Three Treatments for Post-Traumatic Stress Disorder (PTSD)

Exposure therapy, relaxation training and EMDR are three clinical treatments for PTSD. Some researchers say the exposure therapy is more effective.

PTSD Treatment – Exposure Therapy

Exposure therapy means “exposing” patients to the sources of their anxiety. The exposure therapy has various exposure procedures such as “in vivo” exposure and imaginal exposure.

In vivo exposure is also called real life exposure, which exposes the patient to actual fear-inducing situations. For example, a patient with PTSD arising from a traffic collision might be encouraged to return to the scene of the accident.

In imaginal exposure, patients are asked to imagine a situation that they are afraid of. The patients may be asked to talk in the first-person and present tense about the traumatic event and what it means to them at the time and also what they see, hear, smell, feel, and taste.

PTSD Treatment – Relaxation Training

Relaxation training involves breathing techniques, muscle relaxation or meditation.

Breathing relaxation can be as simple as taking deep breaths, or it can take complex forms such as a sequence of breathing at different rates; for instance, starting slowly (4–6 breaths per minute), then at a moderate rate (10–12 breaths per minute), then briefly at a fast rate (80–100 breaths per minute).

Progressive muscle relaxation is a relaxation technique that requires an individual to focus on flexing and holding a certain set of muscles and then slowly relaxing those same muscles. As the individual flexes and releases those muscles from top to bottom they will feel a deep sense of relaxation.

PTSD Treatment – Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a form of psychotherapy in which the patient is asked to recall the memory and its associated features (e.g., negative self-statements) and then lateral sets of eye movements are induced by the therapist moving his/her finger across the patient’s field of vision.

The patient then reports any thoughts, feelings, or images that arose. This new material typically becomes the focus of the next set of eye movements. The process continues until the distress evoked by the memory had subsided.

Comparing Three Treatments

In a 2003 study, a group of researchers recruited 45 people diagnosed with PTSD and randomly assigned the patients into three treatment groups: exposure, relaxation training and EMDR.

The aim of the study was to assess efficacy of the three treatments on each of the four dimensions of PTSD symptoms—reexperiencing, avoidance, numbing, and hyperarousal.

The results show that all three treatments were associated with reductions in PTSD symptoms such as dissociative symptoms and trauma-related anger and guilt. And treatments did not differ in attrition, in the incidence of symptom worsening, or in their effects on numbing and hyperarousal symptoms.

Compared with EMDR and relaxation training, the exposure therapy was more effective as this treatment

  • produced significantly larger reductions in avoidance and reexperiencing symptoms,

  • tended to be faster at reducing avoidance, and

  • tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment.


Sources consulted:

Foa, Edna B. “Prolonged Exposure Therapy: Past, Present, and Future.” Depression and Anxiety, vol. 28, 2011, pp. 1043–1047.

Taylor, Steven, et al. “Comparative Efficacy, Speed, and Adverse Effects of Three PTSD Treatments: Exposure Therapy, EMDR, and Relaxation Training.” Journal of Consulting and Clinical Psychology, vol. 71, no. 2, 2003, pp. 330–338.



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