Practically Speaking: Behind the Episode “The NEW VA/DoD CPG for PTSD: Giving Providers a Fighting Chance”
As many of our listeners know, the Departments of Veterans Affairs and Defense (VA/DoD) Clinical Practice Guideline (CPG) for posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) was released in June of 2023. The CPG, designed to assist clinical decision making, provides recommendations that, in essence, give a clinician a fighting chance of identifying treatments that the research suggests should help their clients. But for many busy providers, it is a lot to unpack and digest!
In this episode of Practical for Your Practice, CDP’s Director, Dr. David Riggs, who served on the CPG workgroup, walks us through important aspects of the guideline.
Dr. Rigg’s emphasizes that the intention of the guideline is not to restrict providers but rather to help clinician’s make informed choices about what the research suggests should help their clients. “ I really think that that's our goal to provide, not restrictions – you don't have to do certain things, but rather guidelines that give you kind of a left and right bumper to say, okay, these are the things you should at least be looking towards.”
So what are the current first and second line psychotherapy treatments for PTSD? Here is the short list:
First line:
- Prolonged Exposure Therapy (PE)
- Cognitive Processing Therapy (CPT)
- Eye Movement Desensitization and Reprocessing (EMDR)
Second line:
- Cognitive Therapy
- Written exposure therapy
- Present Centered Therapy
You might be wondering, why is one treatment considered first line and another second? Dr. Riggs explains, “I do think it's important to let people know again, that we're not saying these are the only treatments that work. In fact, when we talk about first line versus second line treatments, what we're really differentiating there most of the time is the quality of the research, not necessarily the quality of the treatment…The point that I want to make is that that distinction doesn't say that written exposure therapy is less effective than cognitive processing therapy, for example. It simply says the research base isn't as rich as for cognitive processing therapy. So in this case, written exposure therapy is a newer therapy, so it hasn't had as much time to get as much research done on it as some of those other treatments. That's really the distinction that's made there.”
Hungry for more? Be sure to listen to the whole episode where Dr. Rigg’s provides additional information about the process for developing the guideline, decision algorithms included, and other actionable intel and resources to learn more about the CPG’s. As with every episode this season, we invited Dave into the EBP confessional and you won’t want to miss his story of a time when things didn’t quite go according to plan with a client AND how he recovered. Buckle up. It’s a roller coaster of a tale!
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Kevin Holloway, Ph.D., is a licensed clinical psychologist working as Director of Online Training, Technology and Telehealth at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.
As many of our listeners know, the Departments of Veterans Affairs and Defense (VA/DoD) Clinical Practice Guideline (CPG) for posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) was released in June of 2023. The CPG, designed to assist clinical decision making, provides recommendations that, in essence, give a clinician a fighting chance of identifying treatments that the research suggests should help their clients. But for many busy providers, it is a lot to unpack and digest!
In this episode of Practical for Your Practice, CDP’s Director, Dr. David Riggs, who served on the CPG workgroup, walks us through important aspects of the guideline.
Dr. Rigg’s emphasizes that the intention of the guideline is not to restrict providers but rather to help clinician’s make informed choices about what the research suggests should help their clients. “ I really think that that's our goal to provide, not restrictions – you don't have to do certain things, but rather guidelines that give you kind of a left and right bumper to say, okay, these are the things you should at least be looking towards.”
So what are the current first and second line psychotherapy treatments for PTSD? Here is the short list:
First line:
- Prolonged Exposure Therapy (PE)
- Cognitive Processing Therapy (CPT)
- Eye Movement Desensitization and Reprocessing (EMDR)
Second line:
- Cognitive Therapy
- Written exposure therapy
- Present Centered Therapy
You might be wondering, why is one treatment considered first line and another second? Dr. Riggs explains, “I do think it's important to let people know again, that we're not saying these are the only treatments that work. In fact, when we talk about first line versus second line treatments, what we're really differentiating there most of the time is the quality of the research, not necessarily the quality of the treatment…The point that I want to make is that that distinction doesn't say that written exposure therapy is less effective than cognitive processing therapy, for example. It simply says the research base isn't as rich as for cognitive processing therapy. So in this case, written exposure therapy is a newer therapy, so it hasn't had as much time to get as much research done on it as some of those other treatments. That's really the distinction that's made there.”
Hungry for more? Be sure to listen to the whole episode where Dr. Rigg’s provides additional information about the process for developing the guideline, decision algorithms included, and other actionable intel and resources to learn more about the CPG’s. As with every episode this season, we invited Dave into the EBP confessional and you won’t want to miss his story of a time when things didn’t quite go according to plan with a client AND how he recovered. Buckle up. It’s a roller coaster of a tale!
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Kevin Holloway, Ph.D., is a licensed clinical psychologist working as Director of Online Training, Technology and Telehealth at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.