Therapy for C-PTSD requires a longer timeframe regarding treatment. Do you agree or disagree?

[tofubreadcoriander]

NARM Training Institute published it's latest podcast episode. The guest argues that therapy for C-PTSD requires a longer timeframe regarding treatment. Do you agree or disagree?

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“The word ‘evidence-based’ has become a kind of marketing buzzword. It no longer means what people think it means.” - Dr. Jonathan Shedler

On this episode of Transforming Trauma, Emily welcomes author, consultant, researcher, and clinical educator Jonathan Shedler, PhD, to discuss the widening chasm between the research conducted by academic psychologists and real-life psychotherapy.

Speed isn’t an effective treatment for mental health challenges. “That’s the disease,” explains Jonathan. “The goal is to slow things down and create freedom.” Addressing issues like complex PTSD requires a commitment to comprehensive, and generally longer-term therapeutic models like NARM.

We invite you to listen to the full episode and follow Transforming Trauma in Apple Podcasts, Google Podcasts, Spotify, or your favorite podcast app. Transforming Trauma: Episode 114 – NARM Training Institute

 

[Friday]

calling attention to the worrisome trend toward so-called “evidence-based” therapies,

Considering that evidence based treatments often take years, when one is working with complex trauma? How much longer is this bloke advocating for?

 

[abovedown]

My layman take is that any therapy is going to take as long is going to take. I dont think there is a one magic therapy for pstd or cpstd and different therapies work for different people. I think that therapists can often mix approaches from different therapy modes when necessary?

 

[tofubreadcoriander]

Considering that evidence based treatments often take years, when one is working with complex trauma? How much longer is this bloke advocating for?

I listened to the podcast episode and the issue he brings up is that nowadays everything is claimed to be "evidence-based". He has an issue with these type of practices where there isn't a focus on long term healing but on a quick fix. So I guess that's what he meant by putting in quotation marks the word evidence-based.

 

[No More]

I can see both sides.
I can see the side of it takes as long as it takes, sometimes people just need to go slowly & rushing isn’t going to help anyone.


At the same time, I don’t think endless open ended therapy is the answer for anyone. Being so dependent on the therapist that you have no incentive to push through it and do the work because you don’t want to leave isn’t the way either. Long term therapy shouldn’t be the goal because the goal is to build enough into your life as supports such that therapy is unnecessary.

I genuinely think a lot of therapists don’t push hard enough to get their clients out of therapy. IMO leaving early, and having to come back after 6 months for a little too up is the far lesser of two evils

 

[beaneeboo]

My layman take is that any therapy is going to take as long is going to take. I dont think there is a one magic therapy for pstd or cpstd and different therapies work for different people. I think that therapists can often mix approaches from different therapy modes when necessary?

I agree with this (above) whole heartedly

Speed isn’t an effective treatment for mental health challenges. “That’s the disease,” - copied from your original post @tofubreadcoriander .

Who said cptsd is a disease? I think this isn't great terminology to use. One definition of disease is: "a disorder of structure or function in a human, animal, or plant, especially one that has a known cause and a distinctive group of symptoms, signs, or anatomical changes.
"bacterial meningitis is quite a rare disease"

The word disorder doesn't sit right with me either. It intimates something is wrong with the function of the person. Where as often cptsd reactions are a set of normal sypmtoms which have come about as a result of abnormal experiences at the hands of other people. The sypmtoms come about because the brain IS working properly and doing its job... to protect the person. But our systems aren't very sophisticated so what served us well at the time of the trauma then becomes problematic later on when we can't easily switch all that off... when we no longer need those functions...

So CPTSD is not a disorder or a disease imo. And that doesn't mean I'm downplaying the negative impact of it. But if this guy is seeing everything about cptsd through the eyes of it being a disease and disorder its difficult ti get on board with the rest of his reasoning.

At the same time, I don’t think endless open ended therapy is the answer for anyone. Being so dependent on the therapist that you have no incentive to push through it and do the work because you don’t want to leave isn’t the way either. Long term therapy shouldn’t be the goal because the goal is to build enough into your life as supports such that therapy is unnecessary.

I generally agree with this although I guess the line is blurred as to what long term therapy actually is

genuinely think a lot of therapists don’t push hard enough to get their clients out of therapy. IMO leaving early, and having to come back after 6 months for a little too up is the far lesser of two evils

I absolutely agree with this

 

[somerandomguy]

I listened to the podcast episode and the issue he brings up is that nowadays everything is claimed to be "evidence-based".

He's wrong about this. There are very few treatments for PTSD/CPTSD that are truly evidence-based. EMDR, CPT, TF-CBT and Prolonged Exposure Therapy have met the criteria to become gold-star evidence-based therapies; Narrative Therapy is almost as good. Nothing else works nearly as well as these therapies.

The issue, of course, is that not all of these therapies will work equally well for a specific individual, and other, non-evidence-based therapies may work nearly as well for a specific individual.

Treatment protocols are a science. The application of treatment protocols is an art.

 

[No More]

I generally agree with this although I guess the line is blurred as to what long term therapy actually is

Yea absolutely. Personally, just for me - I’d say long term anything is over 6 months, but in terms of therapy I’d say I’d start questioning after maybe 2 years as to how much progress is being made if the person is still reliant on therapy. I’m happy to be told otherwise!

 

[Friday]

He's wrong about this. There are very few treatments for PTSD/CPTSD that are truly evidence-based. EMDR, CPT, TF-CBT and Prolonged Exposure Therapy have met the criteria to become gold-star evidence-based therapies; Narrative Therapy is almost as good. Nothing else works nearly as well as these therapies.

The issue, of course, is that not all of these therapies will work equally well for a specific individual, and other, non-evidence-based therapies may work nearly as well for a specific individual.

Treatment protocols are a science. The application of treatment protocols is an art.

All of this. I kept trying to isolat a piece of it, but… nope. All of it.

 

[beaneeboo]

Yea absolutely. Personally, just for me - I’d say long term anything is over 6 months, but in terms of therapy I’d say I’d start questioning after maybe 2 years as to how much progress is being made if the person is still reliant on therapy. I’m happy to be told otherwise!

Yep I'd agree with this... but I guess for someone else 2 years may be when they are just warming up!... but I agree really with the idea that someone uses a T as substitute family for example...

 

[Movingforward10]

Yea absolutely. Personally, just for me - I’d say long term anything is over 6 months, but in terms of therapy I’d say I’d start questioning after maybe 2 years as to how much progress is being made if the person is still reliant on therapy. I’m happy to be told otherwise!

I'm nearly 4 years in. And trying to see the exit path, but not ready. I can see the progress of me from 0-2 years and from 2-4 years. I can see a lot of progress in the last 9 months alone.
I suppose we all take the time we do.
And I am someone who has a lot of transference and attachment to my T (was about to write "to my parent" rather than "to my T" so there you go!!! Shows it in one perfect sentence!).

 

[Weemie]

NARM Training Institute published it's latest podcast episode. The guest argues that therapy for C-PTSD requires a longer timeframe regarding treatment. Do you agree or disagree?

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Ironically, NARM is not an evidence-based treatment for PTSD. It's just somatic experiencing, which is an "alternative therapy." Snerk. Makes sense why he'd be opposed to the use of "evidence-based" since his treatment doesn't make the cut, yeh? Explains why it feels like he's selling us something, not providing information.