Evaluating the Effectiveness of Phase-Oriented Treatment Models for PTSD-A Meta-Analysis

It has been suggested that treatments for posttraumatic stress disorder (PTSD) be framed within a staged or phase-oriented model, particularly in cases of increased trauma symptom severity and complex PTSD. However, ambiguity remains around this model's definition and efficacy. The present literature review aimed to examine the efficacy of treatments adopting a phase-oriented model for individuals with PTSD symptoms with a subanalysis of a potential high complexity sample. A systematic search of the literature found 1,180 articles, of which 13 met predefined criteria. To analyze effect sizes, a random effects meta-analysis was conducted. The analysis showed a large effect size in the differences between the beginning and end-of-treatment timepoints on PTSD symptoms (d = 1.77, 95% confidence interval [CI] [1.45, 2.08], z = 10.97; p < .001) with moderate heterogeneity. A subanalysis showed that the large effect size was maintained when compared with control groups (d = 0.82, 95% CI [0.29, 2.29], z = 3.04; p < .005). Further subanalysis of a predefined potential high complexity population also revealed a large effect size (d = 1.39, 95% CI [0.99, 1.79], z = 6.79; p < .001). Results concurred with previous literature supporting the effectiveness of phase-oriented models for PTSD symptoms, but limitations existed in finding appropriate definitions of the model, symptom severity, appropriate control groups, and generalizing findings.