Alghamdi et al.(1717 Alghamdi M, Hunt N, Thomas S. The effectiveness of narrative exposure therapy with traumatised firefighters in Saudi Arabia: a randomized controlled study. Behav Res Ther. 2015; 66:64-71. doi: https://doi.org/10.1016/j.brat.2015.01.008 https://doi.org/10.1016/j.brat.2015.01.0...
)/ Saudi Arabia |
Narrative exposure therapy with firefighters (n=34). Four 60-90 minute sessions in 3 weeks. |
Reduction in PTSD symptom scores. Results not maintained after 3 and 6 months. |
Randomized controlled clinical trial / 1B / A. |
Bryant et al.(1818 Bryant RA, Kenny L, Rawson N, Cahill C. Efficacy of exposure-based cognitive behaviour therapy for post-traumatic stress disorder in emergency service personnel: a randomised clinical trial. Psychol Med. 2019;49(9):1565-73. doi: https://doi.org/10.1017/S0033291718002234 https://doi.org/10.1017/S003329171800223...
)/ England |
Cognitive behavioral therapy with emergency responders (n=100). Weekly sessions for 12 weeks. |
Reduction in PTSD symptom scores, anxiety and maladaptation. |
Randomized controlled clinical trial / 1B / A. |
Gersons et al.(1919 Gersons BPR, Carlier IVE, Lamberts RD, Kolk BAVD. Randomized clinical trial of brief eclectic psychotherapy for police officers with posttraumatic stress disorder. J Trauma Stress. 2000;13(2):333-47. doi: https://doi.org/10.1023/A:1007793803627 https://doi.org/10.1023/A:1007793803627...
)/ the Netherlands |
Brief eclectic psychotherapy comprised of psychoeducation, imaginary guidance, writing assignments and memories, domain of meaning or integration, and a farewell ritual for police officers (n=42). Weekly 60-90 minute sessions for 16 weeks. |
Reduction in PTSD symptom scores, with sustained improvement after 3 months of treatment. |
Randomized noncontrolled clinical trial / 2B / B. |
Haugen et al.(2020 Haugen PT, Evces T, Weiss DS. Treating posttraumatic stress disorder in first responders: a systematic review. Clin Psychol Rev. 2012;32(5):3 70-80. doi: https://doi.org/10.1016/j.cpr.2012.04.001 https://doi.org/10.1016/j.cpr.2012.04.00...
)/ USA |
Cognitive therapy associated with virtual reality with police officers, firefighters and lay rescuers (n=21); eye movement desensitization and reprocessing (EMDR) with police officers (n=62); therapy of behavioral activation and prolonged exposure in police officers (n=1); combination of cognitive behavioral therapy and eclectic psychotherapy with police officers (n=42). |
Reduction in PTSD symptom scores in most studies. Except for one study that published an expert opinion about EMDR. |
Systematic review with no meta-analysis / 2A / B. |
Hauger et al.(2121 Hauger PT, Splaun AK, Evces MR, Weiss DS. Integrative approach for the treatment of posttraumatic stress disorder in 9/11 first responders: three core techniques. Psychotherapy (Chic). 2013;50(3):336-40. doi: https://doi.org/10.1037/a0032526 https://doi.org/10.1037/a0032526...
)/ USA |
Cognitive behavioral therapy - integrative psychotherapy comprising emphasis on the generation of meaning, focus on the components with major impact from traumatic exposure, identification and challenge of implicit strategies with lay rescuers, police officers and firefighters, offered weekly. |
Restored 'sense of purpose in life' and 'hope for the future.' |
Case report / 4 / C. |
Haugen et al.(2222 Haugen P, Goldman R, Owen J. Sudden gains and deteriorations in the treatment of posttraumatic stress disorder in World Trade Center responders. J Nerv Ment Dis. 2015; 203(3):205-9. doi: https://doi.org/10.1097/NMD.0000000000000263 https://doi.org/10.1097/NMD.000000000000...
)/ USA |
Integrative psychotherapy with elements of psychodynamics and cognitive behavioral therapy in police officers, firefighters, rescuers (n=36). Weekly sessions for 3-15 weeks |
Reduction in PTSD symptom scores in most participants. About 1/3 of them presented worsened symptoms after 3 sessions. |
Exploratory cohort / 2B / B. |
Lansing et al.(2323 Lansing K, Amen DG, Hanks C, Rudy L. High-resolution brain SPECT imaging and eye movement desensitization and reprocessing in police officers with PTSD. J Neuropsychiatry Clin Neurosci. 2005;1 0(1):526-32. doi: https://doi.org/10.1176/jnp.17.4.526 https://doi.org/10.1176/jnp.17.4.526...
)/ USA |
EMDR in police officers (n=6); 3 3-4 hour sessions. |
Reduction in PTSD symptom scores. Changes in brain imaging tests. |
Randomized noncontrolled clinical trial / 2B / B. |
Lewis-Schroeder et al.(2424 Lewis-Schroeder NF, Kieran KNP, Murphy BLMD, Wolff JDBS, Robinson MA, Kaufman MLMD. Conceptualization, assessment, and treatment of traumatic stress in first responders: a review of critical issues. Harv Rev Psychiatry. 2018;26(4):21 6-27. doi: https://doi.org/10.1097/HRP.0000000000000176 https://doi.org/10.1097/HRP.000000000000...
)/ England |
Cognitive processing therapy, prolonged exposure therapy, and EMDR in emergency responders, prehospital professionals, paramedics, firefighters, and law enforcement officers. Weekly sessions for 12 weeks. |
Reduction in PTSD symptom scores. |
Integrative review with analysis of results / 2C / B. |
Nishi et al.(2525 Nishi D, Koido Y, Nakaya N, Noguchi H, Hamazaki K, Hamazaki T, et al. Fish oil for attenuating posttraumatic stress symptoms among rescue workers after the great east Japan earthquake: a randomized controlled trial. Psychother Psychosom. 2012;81:315-7. doi: https://doi.org/10.1159/000336811 https://doi.org/10.1159/000336811...
)/ Japan |
Fish oil supplementation to relieve PTSD symptoms in emergency physicians and nurses, lay rescuers and mobile medical team who worked in the Great East Japan earthquake (n=450). Seven 320 mg capsules of omega 3 were administered daily for 12 weeks. |
The study did not demonstrate superiority of supplementation with fish oil + psychoeducation over psychoeducation in reducing PTSD symptom scores. Fish oil played an important role in regulating psychological well-being in women. |
Randomized controlled clinical trial / 1B / A. |
Olden et al.(2626 Olden M, Wyka K, Cukor J, Peskin M, Altemus M, Lee F. Pilot study of a telehealth-delivered medication-augmented exposure therapy protocol for PTSD. J Nerv Ment Dis. 2017; 205(2):154-160. doi: https://doi.org/10.1097/NMD.0000000000000563 https://doi.org/10.1097/NMD.000000000000...
)/ USA |
Exposure therapy via telehealth video conferencing for firefighters, police, emergency and military personnel (n=7). Weekly 90-minute sessions for 12-15 weeks. |
Reduction in PTSD symptom scores. |
Randomized noncontrolled clinical trial / 2B / B. |
Richards, Rose(2727 Richards, DA, Rose, JS. Exposure therapy for post-traumatic stress disorder: four case studies. Br J Psychiatry. 1991;158(6):836-40. doi: https://doi.org/10.1192/bjp.158.6.836 https://doi.org/10.1192/bjp.158.6.836...
)/ England |
Cognitive behavioral therapy - in vivo exposure and image exposure among police officers, one electrician and one civilian (n=4). One weekly session of 60 to 90 minutes for 7-11 weeks. |
Reduction in PTSD symptom scores. |
Case report / 4 / C |
Ressler, Mayberg(2828 Ressler KJ, Mayberg HS. Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic. Nat Neurosci. 2007;10:1116-24. doi: https://doi.org/10.1038/nn1944 https://doi.org/10.1038/nn1944...
)/ USA |
Art therapy - assembly of paintings and written expression with military personnel (n=240). Weekly group sessions, for 4 weeks. |
Stronger feelings of hope, positive emotions, socialization, self-awareness of psychological impacts, reduced anxiety. |
Observations of clinical evolution / 2C / B. |
Berberian et al.(2929 Berberian M, Walker MS, Kaimal G. 'Master my demons': art therapy montage paintings by active-duty military service members with traumatic brain injury and post-traumatic stress. Med Humanit. 2019;45(4):353-60. doi: http://dx.doi.org/10.1136/medhum-2018-011493 http://dx.doi.org/10.1136/medhum-2018-01...
)/ USA |
Occupational therapy using sports (surfing) and narrative sessions with military war veterans (n=14). Weekly 4-hour sessions for 5 weeks. |
Reduction in PTSD symptom scores after 5 weeks; reduction of depressive symptoms. |
Cohort study / 2B / B. |
Rogers et al.(3030 Rogers CM, Mallinson T, Peppers D. High-intensity sports for posttraumatic stress disorder and depression: feasibility study of ocean therapy with veterans of operation enduring freedom and operation Iraqi freedom. Am J Occup Ther. 2014;68(4):395-404. doi: http://dx.doi.org/10.5014/ajot.2014.011221 http://dx.doi.org/10.5014/ajot.2014.0112...
)/ USA, Australia, Israel, Croatia, England |
Sports with military war veterans (total n=4,013). Varied duration, according to the study. |
Reduction of stress marker neurotransmitters, increased motivation, reduction in PTSD symptom scores, stronger positive feelings. |
Systematic review with no meta-analysis / 2A / B. |
Whitworth, Ciccolo(3131 Whitworth JW, Ciccolo JT. Exercise and post-traumatic stress disorder in military veterans: a systematic review. Mil Med. 2016; 181:953960. doi: http://dx.doi.org/10.7205/MILMED-D-15-00488 http://dx.doi.org/10.7205/MILMED-D-15-00...
)/ Vietnam, USA |
Mind-body interventions (stress reduction based on mindfulness, in-person and telehealth mind-body therapy and yoga) with military war veterans (total n=479). Sessions varied between weekly 90-minute sessions for 2 weeks, and weekly 90-minute sessions for 12 weeks. |
Reduction in PTSD symptom scores with follow-up assessment. |
Systematic review with no meta-analysis / 2A / B. |
Cushing, Braun(3232 Cushing RE, Braun KL. Mind-body therapy for military veterans with post-traumatic stress disorder: a systematic review. J Altern Complement Med. 2018;24(2):106-14. doi: http://dx.doi.org/10.1089/acm.2017.0176 http://dx.doi.org/10.1089/acm.2017.0176...
)/ USA |
Transcendental meditation with military personnel (n=74). Group and individual sessions of 1.5 to 2 hours, 5 days a week, for 3 months (at least). |
Reduction in the use of psychotropic drugs, reduction in PTSD symptom scores. |
Cohort study / 2B / B. |
Barnes et al.(3333 Barnes VA, Monto A, Williams JJ, Rigg JL. Impact of transcendental meditation on psychotropic medication use among active duty military service members with anxiety and PTSD. Mil Med. 2016;181:56-63. doi: http://dx.doi.org/10.7205/MILMED-D-14-00333 http://dx.doi.org/10.7205/MILMED-D-14-00...
)/ USA |
Mindfulness-based stress reduction with military war veterans (n=8). Weekly group sessions for 8 weeks. |
Reduction in PTSD symptom scores. |
Observations of clinical evolution / 2C / B. |
Bhatnagar et al.(3434 Bhatnagar R, Phelps L, Rietz K, Juergens T, Russell D, Miller N, et al. The effects of mindfulness training on post-traumatic stress disorder symptoms and heart rate variability in combat veterans. J Altern Complement Med. 2013;19(11):860-1. doi: http://dx.doi.org/10.1089/acm.2012.0602 http://dx.doi.org/10.1089/acm.2012.0602...
)/ USA |
Transcendental meditation versus prolonged exposure therapy with military war veterans (n=203). Weekly group and individual sessions for 12 weeks. |
Reduction in similar PTSD symptom scores in both interventions, making transcendental meditation a therapeutic alternative. |
Randomized controlled clinical trial / 1B / A. |
Nidich et al.(3535 Nidich PS, Mills PJ, Rainforth M, Heppner P, Schneider PRH, Rosenthal PNER, et al. Non-trauma-focused meditation versus exposure therapy in veterans with post-traumatic stress disorder: a randomised controlled trial. Lancet Psychiat. 2018;5(12):975-86. doi: http://dx.doi.org/10.1016/S2215-0366(18)30384-5 http://dx.doi.org/10.1016/S2215-0366(18)...
)/ USA |
Horticultural therapy with military war veterans (n=49). Supervised sessions of up to 5 hours a day, for 3 weeks. |
Very small reduction in stress levels and PTSD symptom scores. |
Randomized clinical trial / 2B / B. |
Detweiler et al.(3636 Detweiler MB, Self JA, Lane S, Spencer L, Lutgens B, Kim DY, et al. Horticultural therapy: a pilot study on modulating cortisol levels and indices of substance craving, posttraumatic stress disorder, depression, and quality of life in veterans. Altern Ther Health Med. 2015;21(4):36-41. Available from: https://pubmed.ncbi.nlm.nih.gov/26030115/ https://pubmed.ncbi.nlm.nih.gov/26030115...
)/ Australia |
Animal-assisted therapy using service dogs with military personnel (n=7). |
Increased sense of security, reduced isolation, reduced anxiety, improved sleep, better control of anger, reduced use of medications. |
Case report / 4 / C |
McLaughlin, Hamilton(3737 McLaughlin K, Hamilton AL. Exploring the influence of service dogs on participation in daily occupations by veterans with PTSD: A pilot study. Aust Occup Ther J. 2019;66:648-55. doi: http://dx.doi.org/10.1111/1440-1630.12606 http://dx.doi.org/10.1111/1440-1630.1260...
)/ USA |
Animal-assisted therapy, through interaction with pinnipeds (seals) and military veteran personnel (n=4). Three sessions of 1 hour each, with interactions showing how to take care of and treat the animals. |
Reduction in PTSD symptom scores. |
Case report / 4 / C. |
Wortman et al.(3838 Wortman RA, Vallone T, Karnes M, Walawander C, Daly D, Fox-Garrity B. Pinnipeds and PTSD: an analysis of a human-animal interaction case study program for a veteran. Occup Ther Int. 2018;2018:2686728. doi: http://dx.doi.org/10.1155/2018/2686728 http://dx.doi.org/10.1155/2018/2686728...
)/ USA |
Yoga practice with military veteran personnel (n=25); 22 hours of group yoga practice for 5 days, followed by weekly 2-hour group sessions for 5 months. |
Reduction in PTSD symptom scores, with 6-month follow-up. |
Randomized controlled clinical trial / 1B / A. |
Carter et al.(3939 Carter JJ, Gerbarg PL, Brown R, Ware RS, D'Ambrosio C, Anand L, et al. Multi-component yoga breath program for Vietnam veteran post traumatic stress disorder: randomized controlled trial. Trauma Stress Disor Treat. 2013;2:1-10. doi: http://dx.doi.org/10.4172/2324-8947.1000108 http://dx.doi.org/10.4172/2324-8947.1000...
)/ USA
|
Mindfulness-based stretching and deep breathing exercise (MBX) with nurses (n=29); 16 weekly 60-minute sessions. |
Reduction in serum cortisol levels associated with reduction in PTSD symptom scores. |
Randomized controlled clinical trial / 1B / A. |