In the digital era, being exposed to medical misinformation online is an everyday fact of life. Early research examining how social media, in particular, spreads misinformation about established mental health treatments indicates this occurs when unqualified persons make claims that are not grounded in scientific evidence or state their personal experience or anecdotal observations as fact.
As a psychiatrist, posttraumatic stress disorder (PTSD) specialist, and trauma scientist with more than 25 years of experience, I’ve observed how exposure to misinformation online plays out in the clinic setting with patients who are dealing with symptoms of PTSD. Social media trends may have them convinced there is a strong debate about the efficacy of a particular treatment for PTSD when in fact it is actually a well-established treatment with strong empirical support. Sometimes they are convinced that another “treatment” might work better for them when the scientific data supporting its use is scant to nonexistent. As a clinician, what’s most distressing is when a patient rejects a trial of a treatment that has robust data to support its effectiveness or, worse, chooses an approach the data suggests is harmful to people living with PTSD.
For all these reasons, I felt compelled to highlight results from a recent meta-analysis published in JAMA Psychiatry. A meta-analysis is considered the strongest form of evidence available for a given research question, as it combines data from multiple studies, thus providing a more robust analysis compared to data from individual studies alone. The study authors comprehensively analyzed data pooled from 70 randomized controlled trials of psychological interventions provided for pediatric PTSD. In total, the analysis included data from more than 5,000 children with an average age of 12 years, all of whom had been diagnosed with either PTSD or subthreshold PTSD. The researchers examined the effectiveness of the following four types of therapy:
- TF-CBTs (a cognitive-behavior based therapy with a trauma focus) such as prolonged exposure or cognitive processing).
- EMDR (eye movement desensitization and reprocessing), which utilizes therapist-directed eye movements or other external stimuli as a therapeutic component of the treatment.
- Therapies that were non-trauma-focused.
- Multidisciplinary treatments that combine various therapeutic techniques.
While each type of therapy was found to be more effective in treating pediatric PTSD when compared to waitlist controls, TF-CBTs showed the largest reduction in trauma symptoms. Of note, this symptom improvement was present in the immediate period after treatment and remained six or more months after treatment. EMDR was ranked second in terms of effectiveness, but data to support a maintenance in symptom reduction after six months was lacking. The study authors concluded that “TF-CBTs should be the first line treatment recommendation for pediatric PTSD.”
This meta-analysis helps address a common misperception that trauma-focused therapies are harmful when, in fact, when delivered by a skilled mental health professional, they are not only strongly indicated but also well-established treatments that provide a reduction in PTSD symptoms and a pathway for long-term recovery from trauma.