Article Critique on Therapies.edited

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1 Prolonged Exposure Therapy Vs. Cognitive Processing Therapy Student’s Name Institution Course Professor Date

2 Prolonged Exposure Therapy Vs. Cognitive Processing Therapy Therapy refers to a kind of treatment that proposes to assist in resolving emotional or mental issues (Krouise, 2023). Therapy can assist individuals in dealing with these issues by equipping them with coping skills or by working to eliminate them. Krouse (2023) explains that there are many different types of therapies, including cognitive behavioral therapy, dialectical behavior therapy, exposure therapy, interpersonal therapy, cognitive processing therapy, and mentalization-based therapy, to mention a few. This paper includes an article critique of a research article that compares the efficacy of prolonged exposure therapy to cognitive processing therapy. Prolonged exposure includes a form of cognitive behavioral therapy that teaches people to steadily approach trauma-associated memories, feelings and situations (American Psychological Association, 2017). Cognitive processing therapy assists individuals in learning how to modify and challenge obstructive beliefs associated with trauma (American Psychological Association, 2017). It has been efficient in lessening symptoms of posttraumatic stress disorder (PTSD) that have developed after encountering various traumatic events such as combat, rape, child abuse and natural calamities. The article by Schnurr et al. (2022) compared prolonged exposure to cognitive processing therapy for the treatment of PTSD among US Veterans. The article presents the results of a randomized clinical trial comparing prolonged exposure therapy (PE) and cognitive processing therapy (CPT) for PTSD. The author explained that both therapies portrayed significant reductions in the severity of PTSD. However, PE exhibited slightly better outcomes in the treatment response, loss of diagnosis, and remission likened to CPT. The study revealed that both treatments yielded similar effects on quality of life, functioning and other symptoms.

3 Moreover, there was observation of higher dropout rates in PE, possibly because of session length and the severity of the condition of the participants. The main argument revolves around comparing the efficacy of PE and CPT. The piece establishes a clear reasoning by presenting findings demonstrating meaningful reductions in PTSD severity treatments. Nevertheless, Schnurr et al. (2022) cautiously note that the difference was not clinically significant and identify comparable effects on other symptoms and quality of life. While supporting PE and CPT as primary therapies, the study's nuanced stance refrains from approving one over the other because of these subtle outcome differences and dropout rates. Regarding methodological issues, the clinical trial appears well-structured methodologically, utilizing randomization, informed consent and compliance with reporting guidelines (CONSORT). Nonetheless, possible issues could arise from the randomization process within each site utilizing a 1:1 allocation ratio. The purpose of this approach is to balance groups, but components specific to every site might affect participant allocation, which would then influence the trial's internal validity. Based on the research reviewed, there are several biases observed. One of the biases is selection bias, seen in the high dropout rate, especially in a sample with high severity and comorbidities, which possibly affected the findings. Secondly, there was demographic bias whereby the study predominantly included male veterans, around 710, while the total number of participants was 916. As such, it limits the generalizability to other populations, particularly women and non-veterans. Another study by Rutt et al. (2017) complements the findings of Schurr et al. (2022) regarding the effectiveness of PE and CPT. Rutt et al. (2017) study reveals that both modalities led to a substantial reduction in PTSD symptoms among veterans. The study

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4 by Rutt et al. (2017) also did not portray a clear superiority of one treatment over the other, implying that both therapies are equally efficient. In conclusion, PE teaches people to steadily approach trauma-associated memories, feelings and situations. At the same time, CPT assists individuals in learning how to modify and challenge obstructive beliefs associated with the trauma. It is evident from Schnurr et al. (2022) and Rutt et al. (2017) studies that both PE and CPT therapies demonstrate significant reductions in the severity of PTSD. For this reason, it can be said that both modalities can be used as primary therapies for the treatment of PTSD. Additionally, providing tailored support, personalizing treatment plans and utilizing telehealth can promote the engagement of patients in the sessions of the therapies.

5 References American Psychological Association. (2017). Cognitive processing therapy (CPT). Https://Www.apa.org . https://www.apa.org/ptsd-guideline/treatments/cognitive- processing-therapy American Psychological Association. (2017). Prolonged Exposure (PE). Https://Www.apa.org . https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure Krouse, L. (2023, June 6). 8 Types of Therapy to Consider . EverydayHealth.com. https://www.everydayhealth.com/emotional-health/different-types-of-therapy/ Rutt, B. T., Oehlert, M. E., Krieshok, T. S., & Lichtenberg, J. W. (2017). Effectiveness of cognitive processing therapy and prolonged exposure in the Department of Veterans Affairs. Psychological Reports , 121 (2), 282- 302. https://doi.org/10.1177/0033294117727746 Schnurr, P. P., Chard, K. M., Ruzek, J. I., Chow, B. K., Resick, P. A., Foa, E. B., Marx, B. P., Friedman, M. J., Bovin, M. J., Caudle, K. L., Castillo, D., Curry, K. T., Hollifield, M., Huang, G. D., Chee, C. L., Astin, M. C., Dickstein, B., Renner, K., Clancy, C. P., Collie, C., … Shih, M. C. (2022). Comparison of Prolonged Exposure vs Cognitive Processing Therapy for Treatment of Posttraumatic Stress Disorder Among US Veterans: A Randomized Clinical Trial. JAMA network open , 5 (1), e2136921. https://doi.org/10.1001/jamanetworkopen.2021.36921

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