Post-Traumatic Stress Disorder Psychotherapy - Integrating the Experience of an Emergency



Background. In domestic practice, there are still no clear ideas about effective approaches to psychotherapy, mechanisms of therapeutic effects, as well as principles and algorithms for providing assistance, despite the active development of the problems of PTSD and the presence of an evidence base for the effectiveness of therapy for this group of patients. Objective. The analysis of existing scientific publications on the use of psychotherapy in the treatment of PTSD and the definition of the basic principles and leading methods of psychotherapy used in helping people with PTSD, the formulation of algorithms for psychotherapeutic interventions and the content of the stages included in it. Materials and methods. Literature search was carried out on the databases PubMed, EMBASE, MEDLINE, RSCI and Cochrane Library. Preference was given to the works of the last 5 years. Results. The description of various techniques and techniques of psychotherapeutic interventions is given, the principles of choosing the tactics of psychotherapeutic treatment are considered. The features are noted and the main methods of psychotherapy used for the treatment of PTSD are described. The main mechanisms of the therapeutic effect are given. The methodology and structure of the therapeutic process, the principles of the stages of care and the description of the various stages of psychotherapeutic treatment are considered. Conclusions. Each of the methods of psychotherapy considered in the work has a large evidence base and is focused on trauma, causing a direct appeal to memories of a traumatic event or thoughts and feelings associated with a traumatic event.

General Information

Keywords: post–traumatic stress disorder, PTSD, emergencies, emergency, psychotherapy, psychotherapeutic process, personalized therapy, psychotherapy techniques and methods

Journal rubric: Research Reviews

Article type: scientific article


Received: 14.03.2023


For citation: Vasileva A.V., Karavaeva T.A., Radionov D.S. Post-Traumatic Stress Disorder Psychotherapy - Integrating the Experience of an Emergency. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2023. Vol. 31, no. 3, pp. 47–68. DOI: 10.17759/cpp.2023310303. (In Russ., аbstr. in Engl.)


  1. Vasileva A.V. Post–traumatic stress disorder in the focus of international research: from soldier heart to ICD–11. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova, 2022, vol. 122, no. 10, pp. 72¾81. DOI: 10.17116/jnevro202212210172 (In Russ., abstr. In Engl.)
  2. Vasileva A.V., Karavaeva T.A., Lukoshkina E.P. Diagnostika i terapiya posttravmaticheskogo stressovogo rasstroistva v klinike pogranichnykh rasstroistv i somaticheskoi meditsine [Elektronnyi resurs]. Diagnostika i lechenie psikhicheskikh i narkologicheskikh rasstroistv: sovremennye podkhody. Sbornik metodicheskikh rekomendatsii / sost. N. V. Semenova, pod obshch. red. N. G. Neznanova. Vypusk 2.  SPb.: izdatel'sko–poligraficheskaya kompaniya «KOSTA», 2019. Pp. 300¾324. URL:–content/uploads/2021/05/2019_sbornik_m_vyp_2.pdf (Accesed: 10.02.2023). (In Russ.)
  3. Vasileva A.V., Karavaeva T.A., Lukoshkina E.P., Radionov D.S. Basic approaches to the diagnosis and therapy of post–traumatic stress disorder. V.M. Bekhterev review of psychiatry and medical psychology, 2022. Vol. 56, no. 4, pp. 107¾111. DOI: 10.31363/2313–7053–2022–4–107–111 (In Russ., abstr. In Engl.)
  4. Vasileva A.V., Karavaeva T.A., Neznanov N.G. Psikhoterapiya: uchebnik / pod red. A. V. Vasilevoi, T. A. Karavaevoi, N. G. Neznanova. Moskva: GEOTAR–Media, 2022.  864 p.: il.  DOI: 10.33029/9704–6485–4–VKN–2022–1–86
  5. Karavaeva T.A., Vasileva A.V., Radionov D.S. Сomorbidity of Post–traumatic stress disorder and psychoactive substance abuse: problems of diagnostics, etiology, pathogenesis, and approaches to psychotherapy. Journal of Addiction Problems, 2022, vol. 212, no. 9 (10), pp. 75¾95. DOI: 10.47877/0234–0623_2022_9–10_75 (In Russ., abstr. In Engl.)
  6. Lihi R., Sjempl R. Posttravmaticheskoe stressovoe rasstrojstvo: kognitivnobihevioral'nyj podhod, Moskovskij psihoterapevticheskij zhurnal, 2002, no. 1, pp. 1¾18.
  7. Kholmogorova A.B., Garanjan N.G., Nikitina I.V., Pugovkina O.D. Nauchnye issledovaniya protsessa psikhoterapii i ee effektivnosti: sovremennoe sostoyanie problemy. Ch. 1. Sotsial'naya i klinicheskaya psikhiatriya, 2009, no. 3, pp. 92–100.
  8. Kholmogorova A.B., Garanjan N.G., Nikitina I.V., Pugovkina O.D. Nauchnye issledovaniya protsessa psikhoterapii i ee effektivnosti: sovremennoe sostoyanie problemy. Chast' 2. Sotsial'naya i klinicheskaya psikhiatriya, 2010, no. 1, pp. 70¾79.
  9. Aziraj–Smajić V., Hasanović M. Suicidality in Persons with Post–Traumatic Stress Disorder: What Are the Risk Factors? Psychiatr Danu, 2020, vol. 32 (4), pp. 436¾448.
  10. Bandelow B., Allgulander C., Baldwin D.S., et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive–compulsive and posttraumatic stress disorders – Version 3. Part II: OCD and PTSD [published online ahead of print, 2022 Jul 28]. World J Biol Psychiatry, 2022, pp.1¾17. DOI:10.1080/15622975.2022.2086296
  11. Bertl M., Metsallik J., Ross P. A Systematic Literature Review of AI–based Digital Decision Support Systems for Post–traumatic Stress Disorder. Frontiers in Psychiatry, 2022, vol. 13. DOI: 10.3389/fpsyt.2022.923613
  12. Bisson J.I., van Gelderen M., Roberts N.P., Lewis C. Non–pharmacological and non–psychological approaches to the treatment of PTSD: results of a systematic review and meta–analyses. Eur J Psychotraumatol, 2020, vol. 11, no. 1, p. e1795361. DOI: 10.1080/20008198.2020.1795361
  13. Bisson J.I., Roberts N.P., Andrew M., Cooper R., Lewis C. Psychological therapies for chronic post–traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev, 2013, vol. 12, p. CD003388. DOI:10.1002/14651858.CD003388.pub4
  14. Carl E., Stein A.T., Levihn–Coon A. Virtual reality exposure therapy for anxiety and related disorders: A meta–analysis of randomized controlled trials. J Anxiety Disord, 2019, Vol. 61, pp. 27¾36. DOI: 10.1016/j.janxdis.2018.08.003
  15. Chen L., Zhang G., Hu M., Liang X. Eye movement desensitization and reprocessing versus cognitive–behavioral therapy for adult posttraumatic stress disorder: systematic review and meta–analysis.  J Nerv Ment Dis, 2015, vol. 203, no. 6, pp. 443¾451. DOI: 10.1097/NMD.0000000000000306
  16. Chiba T., Kanazawa T., Koizumi A., Ide K., Taschereau–Dumouchel V., Boku S., Hishimoto A., Shirakawa M., Sora I., Lau H., Yoneda H., Kawato M. Current Status of Neurofeedback for Post–traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback. Front Hum Neurosci, 2019, vol. 17, no. 12, p. 233. DOI: 10.3389/fnhum.2019.00233
  17. Cohen A. Gestalt Therapy and Post–Traumatic Stress Disorder: The Irony and the Challenge. Gestalt Review, 2003, vol. 7, no. 42, 604¾618 pp. DOI: 10.5325/gestaltreview.7.1.0042
  18. Ennis N., Shorer S., Shoval–Zuckerman Y., Freedman S., Monson C.M., Dekel R. Treating posttraumatic stress disorder across cultures: A systematic review of cultural adaptations of trauma–focused cognitive behavioral therapies. J Clin Psychol, 2020, vol. 76, no. 4, pp. 587–611. DOI: 10.1002/jclp.22909
  19. Foa E.B., Hembree E., Rothbaum B., Rauch S. Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences – Therapist Guide Emotional Processing of Traumatic Experiences – Therapist Guide. Oxford University Press, 2019. 146 p.  DOI: 10.1093/med–psych/9780190926939.001.0001
  20. Fonzo G.A., Goodkind M.S., Oathes D.J. Selective Effects of Psychotherapy on Frontopolar Cortical Function in PTSD. Am J Psychiatry, 2017, vol. 174, no. 12, pp. 1175¾1184. DOI: 10.1176/appi.ajp.2017.16091073
  21. Godfrey K., Albright D. Cognitive Processing Therapy. Social Work, 2021, № 1, pp. 12¾24. DOI:10.1093/obo/9780195389678–0297
  22. Heo S., Park J.H. Effects of Virtual Reality–Based Graded Exposure Therapy on PTSD Symptoms: A Systematic Review and Meta–Analysis. Int J Environ Res Public Health, 2022, vol. 19,  no. 23, p. 15911. doi:10.3390/ijerph192315911
  23. Hudays A., Gallagher R., Hazazi A., Arishi A., Bahari G. Eye Movement Desensitization and Reprocessing versus Cognitive Behavior Therapy for Treating Post–Traumatic Stress Disorder: A Systematic Review and Meta–Analysis. Int J Environ Res Public Health, 2022, vol. 19, no. 24, pp. 16836. DOI: 10.3390/ijerph192416836
  24. Kearns N.T., Cloutier R.M., Carey C., Contractor A.A., Blumenthal H. Alcohol and Marijuana Polysubstance Use: Comparison of PTSD Symptom Endorsement and Severity Patterns. Cannabis (Research Society on Marijuana), 2019, vol. 2, no. 13, pp. 9–52.  DOI: 10.26828/cannabis.2019.01.004
  25. Lely J.C.G., Smid G.E., Jongedijk R.A., Knipscheer J., Kleber R.J. The effectiveness of narrative exposure therapy: a review, meta–analysis and meta–regression analysis. Eur J Psychotraumatol, 2019, Vol. 10, no. 1, p. 1550344. DOI: 10.1080/20008198.2018.1550344
  26. Lewis C., Roberts N.P., Andrew M., Starling E., Bisson J.I. Psychological therapies for post–traumatic stress disorder in adults: systematic review and meta–analysis. Eur J Psychotraumatol, 2020, vol. 11, no. 1, p. 1729633. DOI: 10.1080/20008198.2020.1729633
  27. Mavranezouli I., Megnin–Viggars O., Daly C. Psychological treatments for post–traumatic stress disorder in adults: a network meta–analysis. Psychol Med, 2020, vol. 50, no. 4, pp. 542¾555. DOI: 10.1017/S0033291720000070
  28. Park M.J., Kim D.J., Lee U., Na E.J., Jeon H.J. A Literature Overview of Virtual Reality (VR) in Treatment of Psychiatric Disorders: Recent Advances and Limitations. Front Psychiatry, 2019, vol. 10, p. 505. DOI:10.3389/fpsyt.2019.00505
  29. Resick P., Wachen J., Dondanville K., Pruiksma K., Yarvis J., Peterson A., YoungMcCaughan S. Effect of group vs individual cognitive processing therapy in active–duty military seeking treatment for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 2017, vol. 74, no. 1, pp. 28–36. DOI: 10.1037//0022–006x.70.4.867
  30. Roberts N.P., Kitchiner N.J., Kenardy J., Lewis C.E., Bisson J.I. Early psychological intervention following recent trauma: A systematic review and meta–analysis. Eur JPsychotraumatol, 2019, vol. 10, no. 1, p. 169548. DOI: 410.1080/20008198.2019.1695486
  31. Schäfer I., Gast U., Hofmann A. S3 Leitlinie der Deutschsprachigen Gesellschaft für Psychotraumatologie (DeGPT) (Federführende Fachgesellschaft). Version: 19.12.2019 URL:–001l_S3_Posttraumatische_Belastungsstoerung_2019–12.pdf (Accesed: 10.02.2023).
  32. Shapiro F. Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. J. Traum. Stress, 1989, vol. 2, pp. 199¾223. DOI: 10.1002/jts.2490020207
  33. Stanley I.H. Advancements in the understanding of PTSD and suicide risk: Introduction to a special section. Psychol Trauma, 2021, vol. 13, no. 7, pp. 723–724. DOI: 10.1037/tra0001121
  34. Valiente–Gómez A., Moreno–Alcázar A., Treen D., et al. EMDR beyond PTSD: A Systematic Literature Review. Front Psychol, 2017, vol. 8, p. 1668. DOI: 10.3389/fpsyg.2017.01668
  35. van Loenen I., Scholten W., Muntingh A., Smit J., Batelaan N. The Effectiveness of Virtual Reality Exposure–Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, Obsessive–Compulsive Disorder, and posttraumatic stress disorder: Meta–analysis. J Med Internet Res, 2022, vol. 24, no. 2, p. e26736. DOI: 10.2196/26736
  36. Watts B.V., Schnurr P.P., Mayo L., Young–Xu Y., Weeks W.B., Friedman M. J. Meta–analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 2013, vol. 74, no. 6, pp. 541¾550. DOI: 10.4088/JCP.12r08225
  37. Zang Y., Hunt N., Cox T. A randomised controlled pilot study: The effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake. BMC Psychiatry, 2013, vol. 13, no. 1, p. 1. DOI: 10.1186/1471–244X–13–41
  38. Zotev V., Phillips R., Misaki M., Wong C.K., Wurfel B.E., Krueger F., et al. Real–time fMRI neurofeedback training of the amygdala activity with simultaneous EEG in veterans with combat–related PTSD. Neuroimage Clin, 2018, vol. 19. P. 106. DOI: 10.1016/j.nicl.2018.04.010

Information About the Authors

Anna V. Vasileva, Doctor of Medicine, Chief Researcher, Department for Non-psychotic Mental Disorders Treatment and Psychotherapy, V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Associate Professor, Chair of Psychotherapy, Medical Psychology and Sexology, North-Western State Medical Universitynamed after I.I. Mechnikov, St.Petersburg, Russia, ORCID:, e-mail:

Tatiana A. Karavaeva, Doctor of Medicine, Chief Researcher, Head of the Department for Non-psychotic Mental Disorders Treatment and Psychotherapy, V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Professor of the Department of Medical Psychology and Psychophysiology of the St. Petersburg State University; Professor of the Department of General and Applied Psychology with courses in Biomedical Disciplines and Pedagogy of the St. Petersburg State Medical Pediatric University of the Ministry of Health of the Russian Federation; leading researcher of the Scientific Department of Innovative Methods of Therapeutic Oncology and Rehabilitation of the National Research University of Oncology N.N. Petrova" Ministry of Health of Russia; Vice-President of the Russian Psychotherapeutic Association, St.Petersburg, Russia, ORCID:, e-mail:

Dmitriy S. Radionov, Junior Researcher, Department of Treatment of Borderline Mental Disorders and Psychotherapy, V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Saint Petersburg, Russia1, St.Petersburg, Russia, ORCID:, e-mail:



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