Couples therapy for post-traumatic stress disorder (PTSD)
Citation: Suomi A, Evans L, Rodgers B, et al. Couple and family therapies for post‐traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews. 2019;(12):CD011257.
Language: Abstract available in EN, ES, AR, FR and ZH. Plain language summary available in EN, DE, ES, AR, FR, ZH, MS, and JA. Full text available in EN.
Free to view: Yes.
Funding sources: The Australian Catholic University, Australia; University of Melbourne, Australia; University of Bristol, UK; La Trobe University, Australia; the Australian National University, Australia; and the National Health and Medical Research Council, Australia.
What is this? Post-traumatic stress disorder (PTSD), a mental health condition in which symptoms appear after a trauma or stressor, has a large negative impact on patients and their relationships. Couple- and family-based interventions have been suggested for those affected by PTSD to mitigate the effects of the condition on relationships.
In this Cochrane review, the authors searched for randomized trials of the effects of couple or family therapies. They did not restrict their search by language of publication and did the most recent search in 2019. They included 4 randomised trials, which were conducted in Canada (2 studies), Iran (1), and the USA (2), with one of these being done in both the USA and Canada. They also identified one study which is awaiting classification.
What works? Cognitive behavioural conjoint/couple’s therapy (CBCT) was more effective in reducing PTSD severity, anxiety, and depression following treatment compared with controls (low quality evidence).
Structural approach therapy (SAT) was more effective than PTSD family education (PFE) for the same outcomes after treatment (low quality evidence).
What doesn’t work? The included randomised trials comparing CBCT and control as well as those comparing SAT versus PFE, reported no difference in effect for relationship satisfaction, depression, or anxiety symptoms for the partners of patients with PTSD (low quality evidence).
What is uncertain? There is insufficient evidence to clearly conclude the benefit of couple-based therapies compared with other types of therapy and to calculate meaningful differences between two interventions.
Implications: The authors of the review stated that there is limited evidence to allow conclusions to be drawn relating to couple-based therapies in PTSD and whether these provide any benefits when used alone or in combination with additional psychological interventions. They concluded that although couples-based PTSD therapies may be helpful in reducing PTSD symptoms however, there is a need for additional evidence.
Other considerations: The authors of the review did not discuss their findings in the context of issues relating to health equity.
This summary was prepared by Tuba Yavuz, checked by Sneha Bhadti, and finalized by William Summerskill.