So-called “prolonged exposure therapy” is considered the foundation of treatment for soldiers returning from battle with post-traumatic stress disorder. But its effectiveness had never been tried in another group of patients suffering from trauma - adolescent girls who were sexually abused. Now a new study
of the therapy finds it’s better than supportive counseling in helping these young people.
In prolonged exposure therapy - or PET - patients repeatedly revisit and recount aloud the feelings and thoughts that are haunting them until these emotional memories no longer prompt a response. The desensitizing approach is commonly used to treat veterans who are traumatized by their wartime experiences.
Post-traumatic stress disorder, however, is not limited to soldiers. Its symptoms also are seen in adolescent girls following child sexual abuse or rape. Edna Foa, a clinical psychologist at the University of Pennsylvania, said these young women usually receive supportive counseling, which only tends to help sexual abuse victims in the immediate term.
“It kind of reduces the pain in the short run; but in the long run, it actually maintains the symptoms and actually generates chronic post-traumatic stress disorder,” said Foa.
She said teenage girls receiving supportive counseling tend to avoid situations that remind them of their abuse; but Foa, who developed prolonged exposure therapy for PTSD, believes that method can offer the girls a more lasting cure, because it gives them the necessary coping skills to face memories of their assaults.
Foa and her colleagues tailored the PET program to fit the emotional maturity level of adolescents, and compared it to supportive counseling in a group of five dozen sexually abused girls, ages 13 to 18, who suffered from PTSD.
Over a six-year period, each teen received 14 sessions of either the modified PET or supportive counseling. The sessions were about 60 to 90 minutes in length.
During treatment, Foa said adolescents who received prolonged exposure therapy saw a greater decline in PTSD symptoms, depression and a greater improvement in overall functioning compared to those in the supportive care group.
“Most of the girls who received prolonged exposure actually lost the diagnosis of PTSD and really did very well even a year after, because we followed them for up to a year after the treatment.”
Foa said counselors in community mental health centers, where most young sexual abuse victims are seen, can be trained in prolonged exposure therapy in as little as four days.
An article on the therapy’s benefits in female adolescents traumatized by sex abuse is published in The Journal of the American Medical Association
. An editorial that accompanied the report noted that many therapists are reluctant to try the treatment with children because of concerns that it might worsen symptoms, but that the study should raise awareness of the benefits.