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PTSD treatment that works

PTSD is one of the most treatable mental health conditions. Here is how the leading therapies and medicines work, what to expect, and how to find a provider you trust.

A therapist listening to a client in a bright office

You do not have to live with PTSD symptoms forever. Treatment can quiet symptoms, help you take back the parts of life you have been avoiding, and for many people end PTSD altogether. The recommendations below follow the 2023 clinical practice guideline from the U.S. Departments of Veterans Affairs and Defense.

Trauma-focused talk therapy comes first

The treatments with the strongest evidence are trauma-focused psychotherapies. They help you process what happened, change painful beliefs about it, and stop avoidance from running your life. Most are short-term, usually about 8 to 16 sessions.

Cognitive Processing Therapy (CPT)

Usually about 12 weekly sessions. You learn to spot and challenge "stuck points," beliefs such as "It was my fault" or "I will never be safe" that keep you feeling bad.

Prolonged Exposure (PE)

Usually 8 to 15 sessions. With your therapist's support you gradually approach trauma memories and the safe situations you have been avoiding, until they lose their power.

EMDR

Eye Movement Desensitization and Reprocessing. You briefly hold the memory in mind while following eye movements, taps, or tones, which helps the memory feel less vivid and upsetting.

Written Exposure Therapy (WET)

A shorter option of about 5 sessions where you write about the trauma following specific instructions. Studies have found it can work about as well as longer therapies.

Children and teens do well with trauma-focused cognitive behavioral therapy (TF-CBT), which includes their parents or caregivers.

Will I have to tell every detail?

Never before you are ready. A good trauma therapist moves at a pace you can handle, explains each step, and helps you build coping skills first. Feeling more stirred up for a short time early in treatment is common and usually passes as treatment continues.

Medication

Medicines can reduce PTSD symptoms. They are a good choice if therapy is not available, if you prefer medicine, or alongside therapy. The 2023 VA/DoD guideline recommends three antidepressants for PTSD:

  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Venlafaxine (Effexor)

Sertraline and paroxetine are approved by the FDA to treat PTSD. These medicines usually take several weeks to work, and they should not be stopped suddenly without talking to your prescriber.

Help for nightmares

Nightmares are one of the most stubborn PTSD symptoms. Trauma-focused therapy often reduces them. The guideline suggests the medicine prazosin specifically for nightmares, and imagery rehearsal therapy, where you rewrite and practice a new ending to a recurring dream, can also help.

What to avoid

The guideline recommends against using benzodiazepines (such as alprazolam or lorazepam) or cannabis to treat PTSD. They may bring short-term relief, but they do not treat the core symptoms and they carry risks such as dependence. Talk with your doctor before changing any medicine.

Newer and emerging treatments

Researchers are studying several new approaches, including stellate ganglion block, transcranial magnetic stimulation, and psychedelic-assisted therapy. Some look promising, but none has yet been shown to work as reliably as the treatments above, and some are only available in clinical trials. Ask your provider about the evidence before you try them.

What to expect when you start

  • An assessment of your symptoms, history, and goals
  • A shared decision about which treatment fits you best
  • Regular sessions, often weekly, with short practice between sessions
  • Check-ins on your progress using brief questionnaires such as the PCL-5
  • Gradual improvement, with many people noticing changes within the first several weeks

Telehealth works

Research shows PTSD therapy delivered by secure video can work as well as in-person care, which can make treatment much easier to fit into your life.

How to find a trauma-trained therapist

Look for a licensed professional with specific training in at least one of the therapies above. It is completely fine to ask questions before you commit.

FindTreatment.gov

SAMHSA's free, confidential locator for mental health and substance use treatment across the U.S. findtreatment.gov

VA health care

Veterans can get PTSD care at VA medical centers, clinics, and Vet Centers. Questions about eligibility: 877-222-8387.

Your insurance or employer

Your insurer's provider directory or your workplace Employee Assistance Program can point you to covered therapists.

Therapist directories

Directories such as Psychology Today and the EMDR International Association let you search for trauma specialists near you.

Questions to ask a therapist

  • Do you specialize in trauma and PTSD?
  • Which evidence-based PTSD treatments do you provide?
  • How many sessions does treatment usually take?
  • How will we track whether I am getting better?
  • Do you offer telehealth appointments?
  • What does it cost, and do you accept my insurance?

While you wait for treatment, try these coping skills for hard days.

Sources

U.S. Departments of Veterans Affairs and Defense. Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder, 2023.

U.S. Department of Veterans Affairs, National Center for PTSD. PTSD Treatment Basics.

National Institute of Mental Health. Post-Traumatic Stress Disorder.