June 27, 2007

Posttraumatic Stress Disorder and Cognitive Behavioral Therapy—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(24):2694-2695. doi:10.1001/jama.297.24.2695

In Reply: Psychotherapy research is challenging because of the absence of simple placebos used in medication trials. In response to Dr Spielmans and Ms Gatlin, all psychotherapies contain nonspecific elements that occur within the context of a positive psychotherapeutic relationship, including emotional support, decreased isolation, mobilization of hope, and an increased sense of mastery.1 Controlling for these factors when studying the effects of a particular treatment is essential to determine whether there are specific effects of that treatment beyond the effects of these often-powerful elements. This was the intent of present-centered therapy. Thus, Spielmans and Gatlin are correct in saying that present-centered therapy did not specifically reference any established therapeutic approach, although we note that present-centered therapy contained elements of supportive therapy, one of the most commonly practiced treatments.2

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