***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This article describes a second treatment- outcome study of cognitive trauma therapy for battered women with posttraumatic stress disorder ( PTSD ; CTT-BW ) . CTT-BW includes trauma history exploration : PTSD education ; stress management ; exposure to abuse and abuser reminders ; self-monitoring of negative self-talk ; cognitive therapy for guilt ; and modules on self-advocacy , assertiveness , and how to identify perpetrators . One hundred twenty-five ethnically diverse women were r and omly assigned to immediate or delayed CTT-BW .  PTSD remitted in 87 % of women who completed CTT-BW , with large reductions in depression and guilt and substantial increases in self-esteem .  White and ethnic minority women benefited equally from CTT-BW . Similar treatment outcomes were obtained by male and female therapists and by therapists with different levels of education and training . Gains were maintained at 3- and 6-month follow-ups This study tested a family-based skills-building intervention in veterans with chronic combat-related posttraumatic stress disorder ( PTSD ) . Veterans and a family member were r and omly assigned to 1 of 3 conditions : ( a ) waiting list , ( b ) 18 sessions of twice-weekly exposure therapy , or ( c ) 18 sessions of twice-weekly exposure therapy followed by 16 sessions of behavioral family therapy ( BFT ) . Participation in exposure therapy  reduced PTSD positive symptoms ( e.g. , reexperiencing and hyperarousal ) but not PTSD negative symptoms . Positive symptom gains were maintained at 6-month follow-up . However , participation in BFT had no additional impact on PTSD symptoms With a r and omized group design , a 12-session anger treatment was evaluated with severely angry Vietnam War veterans suffering combat-related posttraumatic stress disorder ( PTSD ) . Eight participants in anger treatment and 7 in a routine clinical care control condition  completed multiple measures of anger control , anger reaction , and anger disposition , as well as measures of anxiety , depression , and PTSD at pre- and posttreatment . Controlling for pretreatment scores , significant effects were found on anger reaction and anger control measures but not on anger disposition or physiological measures . Eighteen-months follow-up ( for both completers and dropouts ) supported the posttreatment anger control findings . The challenges of treatment research with this refractory population are discussed Online therapy offers many advantages over face-to-face therapy . Interapy includes psychoeducation , screening , effect measures , and a protocol -driven treatment via the Internet for people suffering from posttraumatic stress . The present article reports the results of a controlled trial on the Internet-driven treatment of posttraumatic stress and grief in a group of people who manifested mild to relatively severe trauma symptoms . Participants in the treatment condition ( n=69 ) improved significantly more than participants in the waiting-list control condition ( n=32 ) on trauma-related symptoms and general psychopathology . The effect sizes were large . On most subscales , more than 50 % of the treated participants showed reliable change and clinical ly significant improvement , with the highest percentages being found for depression and avoidance BACKGROUND Department of Veterans Affairs Cooperative Study 420 is a r and omized clinical trial of 2 methods of group psychotherapy for treating posttraumatic stress disorder ( PTSD ) in male Vietnam veterans . METHODS Vietnam veterans ( 360 men ) were r and omly assigned to receive trauma-focused group psychotherapy or a present-centered comparison treatment that avoided trauma focus . Treatment was provided weekly to groups of 6 members for 30 weeks , followed by 5 monthly booster sessions . Severity of PTSD was the primary outcome . Additional measures were other psychiatric symptoms , functional status , quality of life , physical health , and service utilization . Follow-up assessment s were conducted at the end of treatment ( 7 months ) and at the end of the booster sessions ( 12 months ) ; 325 individuals participated in 1 or both assessment s. Additional follow-up for PTSD severity was performed in a subset of participants at 18 and 24 months . RESULTS Although posttreatment assessment s of PTSD severity and other measures were significantly improved from baseline , intention-to-treat analyses found no overall differences between therapy groups on any outcome . Analyses of data from participants who received an adequate dose of treatment suggested that trauma-focused group therapy  reduced avoidance and numbing and , possibly , PTSD symptoms . Dropout from treatment was higher in trauma-focused group treatment . Average improvement was modest in both treatments , although approximately 40 % of participants showed clinical ly significant change . CONCLUSIONS This study did not find a treatment effect for trauma-focused group therapy . The difference between the effectiveness and adequate dose findings suggests the possible value of methods to enhance the delivery of cognitive-behavioral treatments in clinical practice setting Imagery-rehearsal therapy for  chronic nightmares  was assessed in a r and omized , controlled study of sexual assault survivors with posttraumatic stress disorder ( PTSD ) .  Nightmares , sleep quality , and PTSD were assessed at baseline for 169 women , who were r and omized into two groups :  treatment ( n = 87 ) and wait-list control ( n = 82 ) . Treatment consisted of two 3-hr sessions and one 1-hr session conducted over 5 weeks . Of 169 participants , 91 women ( Treatment , n = 43 , Control , n = 48 ) completed a 3-month follow-up and 78 did not . At follow-up , nightmare frequency and PTSD severity decreased and sleep quality improved in the treatment group with small to minimal changes in the control group . Treatment effects were moderate to high ( Cohen 's d ranged from 0.57 to 1.26 ) . Notwithst and ing the large dropout rate , imagery-rehearsal therapy is an effective treatment for chronic nightmares in sexual assault survivors with PTSD and is associated with improvement in sleep quality and decreases in PTSD severity We examined the feasibility , acceptability , and therapeutic efficacy of a culturally adapted cognitive – behavior therapy ( CBT ) for twelve Vietnamese refugees with treatment-resistant posttraumatic stress disorder ( PTSD ) and panic attacks . These patients were treated in two separate cohorts of six with staggered onset of treatment . Repeated measures Group × Time ANOVAs and between-group comparisons indicated significant improvements , with large effect sizes ( Cohen 's d ) for all outcome measures : Harvard Trauma Question naire ( HTQ ; d=2.5 ) ; Anxiety Sensitivity Index ( ASI ; d=4.3 ) ; Hopkins Symptom Checklist-25 ( HSCL-25 ) , anxiety subscale ( d=2.2 ) ; and Hopkins Symptom Checklist-25 , depression subscale ( d=2.0 ) scores . Likewise , the severity of ( culturally related ) headache- and orthostasis-cued panic attacks improved significantly across On-line therapy offers many advantages over face-to-face setting s. Interapy includes psycho-education , screening , effect measures and protocol -driven treatment via the Internet for clients . The present paper reports the results of a controlled trial on the Interapy treatment of posttraumatic stress and grief in students , gaining course credits . The participants in the experimental condition ( n = 13 ) improved significantly than the participants in the waiting-list control condition ( n = 12 ) , on trauma-related symptoms and general psychopathology . The effect sizes were large . Eighty percent of the treated participants showed clinical ly significant improvement after treatment . The possibilities for future research with Interapy , including studies into moderating variables , are discussed Little is known about the usefulness of psychotherapeutic approaches for traumatized refugees who continue to live in dangerous conditions .  Narrative exposure therapy ( NET ) is a short-term approach based on cognitive-behavioral therapy and testimony therapy . The efficacy of narrative exposure therapy was evaluated in a r and omized controlled trial . Sudanese refugees living in a Ug and an refugee settlement ( N = 43 ) who were diagnosed as suffering from posttraumatic stress disorder ( PTSD ) either received 4 sessions of NET , 4 sessions of supportive counseling ( SC ) , or psychoeducation ( PE ) completed in 1 session . One year after treatment , only 29 % of the NET participants but 79 % of the SC group and 80 % of the PE group still fulfilled PTSD criteria . These results indicate that NET is a promising approach for the treatment of PTSD for refugees living in unsafe conditions OBJECTIVE The authors ' goal was to compare the efficacy of a manualized cognitive behavior therapy that addresses both posttraumatic stress disorder ( PTSD ) and substance abuse ( seeking safety ) with a manualized cognitive behavior therapy that addresses only substance abuse ( relapse prevention ) and with st and ard community care for the treatment of comorbid posttraumatic stress disorder ( PTSD ) and substance use disorder . METHOD One hundred seven women from an urban , low-income population who had comorbid PTSD and substance use disorder were r and omly assigned to receive the two kinds of cognitive behavior therapy or received st and ard community treatment .  Participants were recruited from both community and clinical population s and evaluated with structured clinical instruments . Forty-one women received seeking safety therapy , 34 received relapse prevention therapy , and 32 received st and ard community care . RESULTS At the end of 3 months of treatment , participants in both cognitive behavior therapy conditions had significant reductions in substance use , PTSD , and psychiatric symptoms , but community care participants worsened over time . Both groups receiving cognitive behavior therapy sustained greater improvement in substance use and PTSD symptoms at 6-month and 9-month follow-ups than subjects in the community care group . CONCLUSIONS Seeking safety and relapse prevention are efficacious short-term treatments for low-income urban women with PTSD , substance use disorder , and other psychiatric symptoms In an attempt to develop a brief treatment for disaster survivors , the present study examined the effectiveness of a single session of modified behavioral treatment in earthquake-related posttraumatic stress disorder . Fifty-nine earthquake survivors in Turkey were r and omized into either single-session modified behavioral treatment ( SSBT ) design ed to enhance sense of control over earthquake-related fears or waiting list control condition ( WL ) . The WL group received SSBT after a second baseline assessment . Follow-ups were at weeks 6 , 12 , 24 , and at 1 - 2 years posttreatment . Significant treatment effects were found on all measures at posttreatment . The improvement rate was 49 % at week 6 ; it rose to 80 % by week 12 , 85 % by week 24 , and 83 % by the 1 - 2-year follow-up . Brief behavioral treatment has promise as a cost-effective intervention for disaster survivors CTT-BW includes trauma history exploration , PTSD psychoeducation , stress management , psychoeducation about dysfunctional self-talk and self-monitoring of self-talk , exposure to abuse reminders , Cognitive Therapy for Trauma-Related Guilt ( E. S. Kubany & F. P. Manke , 1995 ) , and modules on assertiveness , managing contacts with former partners , self-advocacy strategies , and avoiding revictimization . Thirty-seven ethnically diverse women were assigned to Immediate or Delayed CTT-BW .  PTSD remitted in 30 of 32 women who completed CTT-BW . Gains were maintained at 3-month follow-up . CTT-BW was efficacious across ethnic background s. Issues related to disseminability of CTT-BW are discussed Fifty-eight women with posttraumatic stress disorder ( PTSD ) related to childhood abuse were r and omly assigned to a 2-phase cognitive-behavioral treatment or a minimal attention wait list . Phase 1 of treatment included 8 weekly sessions of skills training in affect and interpersonal regulation ; Phase 2 included 8 sessions of modified prolonged exposure . Compared with those on wait list , participants in active treatment showed significant improvement in affect regulation problems , interpersonal skills deficits , and PTSD symptoms . Gains were maintained at 3- and 9-month follow-up . Phase 1 therapeutic alliance and negative mood regulation skills predicted Phase 2 exposure success in reducing PTSD , suggesting the value of establishing a strong therapeutic relationship and emotion regulation skills before exposure work among chronic PTSD population The logic of the r and omized double-blind placebo control group design is presented , and problems with using the design in psychotherapy are discussed .  Placebo effects are estimated by examining clinical trials in medicine and psychotherapy . In medicine , a recent meta- analysis of clinical trials with treatment , placebo , and no treatment arms was conducted ( Hróbjartsson & Gøtzsche , 2001 ) , and it was concluded that placebos have small or no effects . A re- analysis of those studies , presented here , shows that when disorders are amenable to placebos and the design is adequate to detect the effects , the placebo effect is robust and approaches the treatment effect . For psychological disorders , particularly depression , it has been shown that pill placebos are nearly as effective as active medications whereas psychotherapies are more effective than psychological placebos . However , it is shown that when properly design ed , psychological placebos are as effective as accepted psychotherapies This study compared the effectiveness of cognitive processing therapy for  sexual abuse survivors  ( CPT-SA ) with that of the minimal attention ( MA ) given to a wait-listed control group .  Seventy-one women were r and omly assigned to 1 of the 2 groups . Participants were assessed at pretreatment and 3 times during posttre 
    Output:
    
Conclusions : These findings suggest that specific therapies , such as CBT , exposure therapy and cognitive therapy are equally effective , and more effective than supportive techniques in the treatment of PTSD