Interpersonal Therapy Found as Effective as Exposure Therapy for PTSD – Findings Suggest a New Avenue for Treatment

March 26, 2015

New York, NY (March 25, 2015) -- A head-to-head comparison of exposure therapy and interpersonal psychotherapy (IPT) for post-traumatic stress disorder (PTSD) found that IPT, a talk therapy that focuses on feelings and relationships rather than on the trauma a patient suffered, was as effective as exposure therapy. The study, published in the American Journal of Psychiatry online in March 2015, is the first to compare the two treatments.

Exposure therapy, a type of cognitive-behavioral therapy (CBT), is considered the gold standard in PTSD treatment. It requires that patients—in a controlled setting—confront their fears gradually over time, to reduce their anxiety. Because of the nature of the treatment, many patients have difficulty with it.

“There are effective treatments for PTSD, mostly psychotherapies, and almost entirely psychotherapy focusing on exposing patients to frightening reminders of their traumas,” said John Markowitz, MD, professor of clinical psychiatry at Columbia University Medical Center and research psychiatrist at the New York State Psychiatric Institute. “The cognitive behavioral approach works, has the most evidence to support it, and has dominated both research and clinical treatment. But it’s not perfect: Exposure-based treatment doesn’t benefit everyone, and it asks patients to do what they’re most afraid of doing.”

Dr. Markowitz and his colleagues recruited 110 non-medicated patients with chronic PTSD and randomized them to receive one of three treatments over 14 weeks: prolonged exposure, IPT, or relaxation therapy. While the researchers found little difference between the exposure therapy and IPT groups in PTSD outcome, IPT had advantages for the half of patients who also had major depression.

“The results suggest a whole new avenue of treatment for individuals with chronic PTSD,” said Dr. Markowitz. “They also raise a range of research questions: Instead of the fear-extinction circuit underlying exposure-based treatment, might some disruption in attachment explain why IPT works?”

He added, “We’d like to replicate the results before claiming any long-term consequences. But if the findings hold, a range of psychotherapists who don’t practice CBT, and a range of patients who either don’t respond to CBT or refuse it, might benefit from this approach.”


The co-authors, all from Columbia University Medical Center and the New York State Psychiatric Institute, are Eva Petkova, PhD; Yuval Neria, PhD; Page Van Meter, PhD; Yihong Zhao, PhD; Elizabeth Hembree, PhD; Karina Lovell, PhD; Tatyana Biyanova, PhD; and Randall Marshall, MD.

The study was funded by NIMH grant R01 MH079078 (Dr. Markowitz).

Dr.Markowitz receives research funding from NIMH; royalties from American Psychiatric Publishing, Basic Books, and Oxford University Press; and an editorial stipend from Elsevier Press. Dr. Hembree receives royalties from Oxford University Press. Dr. Marshall is an employee of Retrophin and has been an employee of Alkermes.


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InPsych - March 2015, Press Releases