Psychotherapy for posttraumatic stress disorder

Clinical practice guidelines for posttraumatic stress disorder (PTSD) from various agencies recommend trauma-focused psychotherapies as the first-line treatment. Commonly recommended therapies include Prolonged Exposure Therapy, Cognitive Processing Therapy, and Eye Movement Desensitization and Reprocessing. After introducing the core elements of empirically supported psychotherapies for PTSD, this paper focuses first on Prolonged Exposure Therapy, which has been covered by health insurance in Japan since 2016, explaining its theoretical foundation and treatment details. The second half of the paper addresses therapeutic approaches for complex PTSD, newly adopted in the International Classification of Diseases, 11th Revision (ICD-11). Given the more pervasive and multifaceted nature of complex PTSD, treatment guidelines recommend integrating multiple therapeutic components to address these broader challenges. Trauma-focused therapies may need to be adapted to accommodate the specific needs of individuals with complex PTSD. In this context, the paper introduces Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy, a multicomponent therapeutic model specifically designed for complex PTSD.