Summary: The most effective therapy for adults PTSD – post-traumatic stress disorder – is a combination of cognitive-behavioral therapies and controlled exposure therapies.
Key Points:
- Post-traumatic stress disorder (PTSD) can develop as a response to traumatic experiences during childhood or adulthood
- The long-term consequences of untreated PTSD can cause significant disruption across life domains, including work, school, and relationships
- Evidence-based treatment for adult PTSD is both effective and accessible
Treatment and Therapy for Adult PTSD
In a paper published recently in the Journal of the American Medical Association (JAMA) called “Loss of PTSD Diagnosis in Response to Evidence-Based Treatments: A Systematic Review and Meta-Analysis,” a group of research scientists conducted a comprehensive study of existing literature on post-traumatic stress disorder (PTSD) designed to answer the following question:
What proportion of patients lose their posttraumatic stress disorder (PTSD) diagnosis after receipt of evidence-based psychotherapies?
The research team collected data for their meta-analysis from a nationwide PTSD Repository that “contains information extracted from 550 published randomized controlled clinical trials for PTSD treatment” established by the Department of Veterans Affairs and maintained by the U.S. National Center for PTSD.
Of the 496 studies available at the time – the database now contains 550 – researchers chose studies with the following characteristics:
- Had PTSD as the primary treatment target.
- Reported results on psychotherapy as a monotreatment.
- Included loss of PTSD diagnosis as an outcome.
That narrowed the field to 34 random clinical trials (RCTs) with a total of 3,208 participants. The research team chose loss of PTSD diagnosis as a primary outcome for clarity and clinical utility. Since there’s wide variation in the way studies on effective therapy for PTSD in adults assess effective therapy for PTSD in adults – some use loss of PTSD diagnosis, others use reliable symptom reduction, and others use significant improvement on PTSD screenings – the researchers settled on loss of PTSD diagnosis for the following reason:
“The variety of methods for defining treatment response underscores the difficulty of identifying when someone has made meaningful clinical gains.”
The use of a clear criterion – loss of PTSD diagnosis by DSM IV or DSM-5 measures – avoids this difficulty and allows future clinicians and researchers to use the results of this study to gain an understanding of how various therapeutic approaches to PTSD work in real-world, clinical circumstances.
What Do We Know About Effective Therapy for PTSD in Adults in 2025?
Since the 1980s, mental health professionals have developed and/or adapted several psychotherapeutic approaches to support patients diagnosed with PTSD. While PTSD is most often associated with military veterans, research conducted since the 1980s shows PTSD can develop in both military and non-military populations as a maladaptive response to a wide range of traumatic experiences.
To date, experts consider the following approaches as effective therapy for adult PTSD:
- Cognitive behavioral therapy (CBT)
- Cognitive processing therapy (CPT)
- Prolonged exposure (PE)
- Eye movement desensitization and reprocessing (EMDR)
- Cognitive therapy for PTSD (CT-PTSD)
Three of those approaches – CBT, CPT, and CT-PTSD – use cognitive behavioral therapy (CBT) as a foundation, which means they adapt the following fundamental therapeutic principles to PTSD treatment:
“CBT focuses on examining the relationships between thoughts, feelings and behaviors. By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping.”
To adapt CBT as an effective therapy for Adult PTSD, therapists combine it with the concept of exposure, which is a stepwise, safe, and controlled process by which therapists gradually expose patients to memories of the initial traumatic event or triggers that cause symptoms of PTSD associated with the initial traumatic event. Controlled, safe, mutually agreed-upon exposure is a fundamental component of prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR).
Before we share the results of the study on effective therapy for adult PTSD, we’ll share the latest prevalence statistics, as provided by the National Center for PTSD, which we link to above.
Prevalence of PTSD in the U.S.
Among all Adults 18+:
- Clinical PTSD in past 12 months: 5%
- Clinical PTSD ever during lifetime: 6%
Among U.S. Military Veterans:
- Ever diagnosed with PTSD: 9%
- Female veterans: 13%
- Male veterans: 6%
- Among veterans with combat deployment:
- Past 12 months: 9%
- Lifetime: 16%
Now let’s take a look at that new study.
Effective Therapy for Adult PTSD: What Works?
The research team included another category of treatment we didn’t mention above: patients with PTSD put on a waitlist or received minimal attention for PTSD symptoms. Among those patients, 13 percent of veterans reported loss of PTSD diagnosis, and 11 percent of non-military adults reported loss of PTSD diagnosis.
Here are the results for adult patients with PTSD who engaged in one of the five treatments we list above.
The Results: What’s the Best Therapy for Adult PTSD?
Cognitive behavioral therapy (CBT):
- 9 studies, 398 patients
- Loss of PTSD diagnosis total: 61%
- Military veterans: 46%
- Non-military adults: 65%
Cognitive processing therapy (CPT):
- 6 studies, 607 patients
- Loss of PTSD diagnosis total: 57%
- Military veterans: 44%
- Non-military adults: 69%
Prolonged exposure (PE):
- 9 studies, 1017 patients
- Loss of PTSD diagnosis total: 56%
- Military veterans: 50%
- Non-military adults: 66%
Eye movement desensitization and reprocessing (EMDR):
- 5 studies, 343 patients
- Loss of PTSD diagnosis: 86%
Data on military/non-military status n/a
Cognitive therapy for PTSD (CT-PTSD):
- 3 studies, 103 patients
- Loss of PTSD diagnosis: 76%
Data on military/non-military status n/a
Upon first review, it appears as if EMDR is the most effective therapy for adult PTSD. However, the study authors advise a conservative approach to this outcome:
“While our findings indicate possible superiority of EMDR with respect to diagnosis loss, this warrants further research. None of the included EMDR studies were conducted in [military veteran] populations or in the U.S.”
That’s a good summary of how we understand EMDR: some studies show effectiveness, and for some patients, EMDR is effective when other approaches aren’t. However, due to the lack of clarity around the evidence for EMDR, we’ll leave it off our most effective therapy for adult PTSD list – for now. In the absence of EMDR, here’s our list, in order of effectiveness:
Top Four Treatments for PTSD
- Cognitive therapy for PTSD (CT-PTSD): 76% of patients report loss of diagnosis
- Cognitive behavioral therapy (CBT): 61% of patients report loss of diagnosis
- Cognitive processing therapy (CPT): 57% of patients report loss of diagnosis
- Prolonged exposure (PE): 56% of patients report loss of diagnosis
We’ll discuss these results below.
The Importance of Effective Therapy for Adult PTSD: Treatment Makes a Difference
One thing we mention earlier in this article is the fact that most people associate PTSD with military combat veterans. It’s a logical association, because that’s the context within which and the population within which PTSD was initially identified and treated.
However, we now know that non-combat trauma can cause PTSD, too. The following list describes adverse childhood experiences (ACEs) that are associated with PTSD. Evidence shows that experience of these events at any time during life – not just during childhood – is associated with the development of PTSD.
Experiences that may lead to PTSD:
- Abuse: sexual, physical, emotional
- Neglect: physical or emotional
- Violence:
- Direct experience of violence in home or neighborhood
- Seeing violence in home or neighborhood
- Mental health/behavioral health issues: having a family member with a clinical mental health disorder or substance/alcohol use problem
- Justice system involvement: incarceration of family member
- Direct experience of racism
- Economic hardship
To be clear, these experiences increase risk of and are associated with the development of PTSD. In some cases, people who experience these adverse events do not develop PTSD. However, the presence of these experiences increases risk of the following:
- Chronic physical disease
- Mental and/or behavioral health disorders
- Impaired work and school performance
- Problems with relationships
Those problems can be serious and disruptive, especially if they combine with the possible consequences of untreated PTSD, which may include:
- Depressed mood
- Aggressive behavior
- Anger/irritability
- Emotion regulation problems
- Self-isolation/withdrawal from friends or family
- Suicidality, including suicidal ideation and/or suicide attempts
For a more detailed discussion of PTSD, please read our PTSD Awareness Month article:
PTSD Awareness Month 2025: Help Raise Awareness During June
That article includes more information on PTSD, including various ways to raise awareness about PTSD in communities around the country.
How This Information Helps Our Patients
The idea behind the study we focus on in this article is to identify the most effective therapy for adult PTSD, using a metric that’s simple and easy to understand: loss of PTSD diagnosis. This study helps us prioritize the collaborative, shared decision-making process that’s at the core of our treatment model. We work with patients and their families to identify their current problems, determine treatment goals, and devise a plan to achieve those treatment goals.
With studies like this one, we can present data that’s unambiguous, and use phrases like loss of PTSD diagnosis, which is easy to understand, because it sounds like remission, rather than clinically significant symptom reduction, which isn’t necessarily difficult to understand, but not as direct and immediately relatable as a phrase like loss of PTSD diagnosis.
In the end, what we want adult patients with PTSD to understand is this: effective, evidence-based treatment for PTSD is available. In most cases, treatment enables patients to manage symptoms and lead full and productive lives. And in other cases, treatment can lead to loss of PTSD diagnosis, which is the ultimate goal of treatment.
