The effectiveness of Prolonged Exposure (PE) and Eye Movement Desensitization and Reprocessing (EMDR) in treating Posttraumatic Stress Disorder (PTSD) has been well established. Indeed, they are recommended as first line treatments for PTSD in international treatment guidelines.
People who experience psychosis have traditionally been excluded from these trials. This is despite the fact that PTSD is a common comorbidity in psychosis (with 12.4% of people with psychosis also meeting criteria for PTSD) and that the presence of PTSD is associated with worse social and psychiatric outcomes in this group. The biological and psychological sequelae of trauma are also implicated in the genesis and maintenance of psychosis itself.
There has been some preliminary evidence for trauma-focused therapies being safe and effective for people experiencing psychosis. Despite this, the status quo of exclusion of people with psychosis from receiving evidence-based treatments for PTSD symptoms has remained. Van den Berg and colleagues’ RCT is long overdue and is a potential game changer in the landscape of psychological treatments for people experiencing psychosis… I hope.