Synopsis of Treatment Research:

Early referral for treatment has the potential to improve outcome rates.  While exposure to a traumatic incident does not result in PTSD for most people, screening and education regarding early intervention may be a good idea.

Severity of initial symptoms and type of trauma (e.g., sexual assault, MVA) may offer particular indications that early referral is a good idea. 

Preliminary findings are that the early intervention (+/- 2 weeks post trauma) of choice may be a modification of Foa’s protocol for Prolonged Exposure (86-92% of treated group was PTSD-free, vs. 26-44% of control group, which was either untreated or got supportive counseling; 6 months post-trauma 83-85% of PE group was PTSD-free, vs. 30-33% of those who received supportive counseling).  This treatment also markedly reduced incidence of depression.  

If PTSD symptoms haven’t resolved by 3-6 months, they are unlikely to spontaneously remit and treatment is indicated.  Treatment of choice is Foa’s protocol for Prolonged Exposure (generally, 75-80% of participants have >70% reduction in symptoms; low relapse rate; many Tx responders’ symptoms continue to diminish even after therapy has ended).  Stress Inoculation Training may provide a good second alternative.   The FDA has approved Zoloft (53-63% of participants have >30% reduction in symptoms;

For people with pervasive dysfunction and/or high comorbidity or risk, Prolonged Exposure may not be appropriate.  Treatment including multiple modalities such as medication, psychotherapy, family therapy, and rehabilitation therapy may be preferable.