Does CBT have lasting effects in the treatment of PTSD after one year of follow-up? A systematic review of randomized controlled trials
Open accessAbstract
INTRODUCTION: While several previous meta-analyses have documented the short-term efficacy of cognitive-behavioral therapy (CBT), its long-term efficacy remains unknown. Posttraumatic stress disorder (PTSD) is a serious, debilitating, often chronic and disabling disease. OBJECTIVE: To estimate the long-term efficacy of CBT in the treatment of PTSD by assessing the maintenance of the effect after one year of follow-up. METHOD: We performed a systematic review through electronic database searches including ISI Web of Science, PubMed, PsycInfo and Pilots. We included randomized studies in which CBT was compared with a control group (waiting list or usual care) in adults with PTSD that reported at least one year of CBT follow-up. RESULTS: Our search identified 2,324 studies and 8 were selected. CBT was shown to be effective in the treatment of PTSD in the post-treatment period. Improvement in PTSD symptoms was statistically significant in relation to the control group. The improvement observed in the treatment group or single group (formed by both treatment group and control group, which was submitted to the intervention after a few weeks on the waiting list) was maintained in the follow-up. CONCLUSION: Due to the lack of control groups in the follow-up period in six of the eight studies included in this review, there is still no proper methodological basis to assert that CBT has lasting effects in the treatment of PTSD. Our study found serious methodological shortcomings and the need to fill this gap in the literature through the development of studies with robust and sophisticated designs.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
CBT is effective in the post-treatment phase of PTSD, indicating its effects endure.
“Studies have shown that CBT is effective in the post-treatment phase of PTSD, indicating that its effects endure [68].”
From Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. (2024) · cites this paper as [68]
The Results report significantly greater post-treatment reductions in PTSD symptoms with CBT than in control groups across all eight studies, and say the improvements were maintained at follow-up. However, the Conclusion cautions that methodological limitations prevent firm conclusions about CBT’s long-term efficacy for PTSD, so the claim overstates how securely its effects can be said to endure. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00136 · Cited by 10,349 · see citing works
A Multidimensional Meta-Analysis of Psychotherapy for PTSD
Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.2.214 · Cited by 1,938 · see citing works
Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.67.2.194 · Cited by 1,060 · see citing works
Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A. M., Riggs, D. S., Feeny, N. C., & Yadin, E. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.5.953 · Cited by 931 · see citing works
Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S., Richards, D., & Turner, S. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.021402 · Cited by 900 · see citing works
Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.67.2.194 · Cited by 808 · see citing works
Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. H. (2016) · World Psychiatry · doi:10.1002/wps.20346 · Cited by 572 · cited 5× · see citing works
“2018;40(4) – 357 Does CBT have lasting effects in PTSD? - Macedo et al.”
BackgroundInfluentialMohr, D. C., Spring, B., Freedland, K. E., Beckner, V., Arean, P., Hollon, S. D., Ockene, J., & Kaplan, R. (2009) · Psychotherapy and Psychosomatics · doi:10.1159/000228248 · Cited by 565 · see citing works
Enduring Effects for Cognitive Behavior Therapy in the Treatment of Depression and Anxiety
Hollon, S. D., Stewart, M. O., & Strunk, D. (2006) · Annual Review of Psychology · doi:10.1146/annurev.psych.57.102904.190044 · Cited by 466 · see citing works
Chard, K. M. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.5.965 · Cited by 403 · see citing works
Nexhmedin Morina, B., Wicherts, J. M., Lobbrecht, J., & Priebe, S. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.03.002 · Cited by 321 · see citing works
Sijbrandij, M., Kunovski, I., & Cuijpers, P. (2016) · Depression and Anxiety · doi:10.1002/da.22533 · Cited by 213 · see citing works
Power, K., McGoldrick, T., Brown, K., Buchanan, R., Sharp, D., Swanson, V., & Karatzias, A. (2002) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.341 · Cited by 203 · see citing works
Relapse and recurrence prevention in depression: Current research and future prospects
Beshai, S., Dobson, K. S., Bockting, C. L. H., & Quigley, L. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.09.003 · Cited by 165 · see citing works
Mueser, K. T., Gottlieb, J. D., Xie, H., Lu, W., Yanos, P. T., Rosenberg, S. D., Silverstein, S. M., Marcello, S. C., Minsky, S. K., Wolfe, R. S., et al. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.147926 · Cited by 121 · see citing works
コクラン共同計画の無作為化試験におけるバイアスリスク評価ツール | 文献情報 | J-GLOBAL 科学技術総合リンクセンター
T, H. J. P., Altman, D. G., Gotzsche Peter, C., Peter, J., David, M. M., Oxman Andrew, D., Savović, J., Schulz, K. F., Weeks, L., & Sterne, J. A. C. (2011) · Cited by 110 · see citing works
Prolonged Exposure Therapy for Combat- and Terror-Related Posttraumatic Stress Disorder
Nacasch, N., Foa, E. B., Huppert, J. D., Tzur, D., Fostick, L., Dinstein, Y., Polliack, M., & Zohar, J. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05682blu · Cited by 102 · see citing works
Long-term effects of an internet-based treatment for posttraumatic stress
Knaevelsrud, C., & Maercker, A. (2010) · Cognitive Behaviour Therapy · doi:10.1080/16506070902999935 · Cited by 76 · see citing works
Asukai, N., Saito, A., Tsuruta, N., Kishimoto, J., & Nishikawa, T. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20589 · Cited by 70 · see citing works
Flückiger, C., Del Re, A. C., Munder, T., Heer, S., & Wampold, B. E. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.05.001 · Cited by 34 · see citing works
Flagged first, then by citations
Research works printed but not linked: 6
- Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of. Arch Gen Psychiatry. 2005;62:593-602.
- Pagotto LF, Mendlowicz MV, Coutinho ESF, Figueira I, Luz MP, Araujo AX, et al. The impact of posttraumatic symptoms and comorbid mental disorders on the health-related quality of life in treatment-seeking PTSD patients. Compr Psychiatry. 2015;58:68- 73.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington: American Psychiatric Publishing; 2013.
- Cusack K, Jonas DE, Forneris CA, Wines C, Sonis J, Middleton JC, et al. Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clin Psychol Rev. 2016;43:128-41.
- Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev. 2013;12:1-248.
- Review Manager (RevMan) Version 5.3 [computer program]. Cochrane Community; 2014. https://community.cochrane.org/ help/tools-and-software/revman-5
Cited by
Sorted by citations
Fordham, B., Sugavanam, T., Edwards, K., Hemming, K., Howick, J., Copsey, B. J., Lee, H., Kaidesoja, M., Kirtley, S., Hopewell, S., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25090 · Cited by 59 · see citing works
Gkintoni, E., Kourkoutas, E., Yotsidi, V., Stavrou, P. D., & Prinianaki, D. (2024) · Children · doi:10.3390/children11050579 · Cited by 37 · see citing works
“Studies have shown that CBT is effective in the post-treatment phase of PTSD, indicating that its effects endure [68].”
BackgroundGillespie, C., Murphy, M. F., & Joyce, M. (2022) · Journal of Personality Disorders · doi:10.1521/pedi.2022.36.4.431 · Cited by 26 · see citing works
Protocol for individual participant data meta-analysis of interventions for post-traumatic stress
Wright, S. L., Karyotaki, E., Bisson, J. I., Cuijpers, P. J., Papola, D., Witteveen, A. B., Seedat, S., & Sijbrandij, M. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054830 · Cited by 16 · see citing works
Chen, Y., Lam, C. S., Deng, H., & Ko, K. Y. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.691765 · Cited by 13 · see citing works
“Our previous randomized controlled studies also suggested that CBT was effective at reducing PTSD symptoms (27, 28).”
MethodBisson, J. I., Ariti, C. A., Cullen, K., Kitchiner, N., Lewis, C., Roberts, N. P., Simon, N. A., Smallman, K., Addison, K., Bell, V., et al. (2023) · Health Technology Assessment · doi:10.3310/ytqw8336 · Cited by 8 · see citing works
Gesteira, C., García‐Vera, M. P., Sanz, J., & Shultz, J. M. (2025) · Psychotherapy Research · doi:10.1080/10503307.2025.2467380 · Cited by 3 · see citing works
“Among the WL RCTs included in Macedo et al. (2018) meta-analysis, some reported between-groups effect sizes that went from 1.52 to 1.92 in the case of completers (Chard, 2005; Foa et al., 1999).”
InfluentialThe assessment of mobbing damage: when the psychological pain becomes physical
Galletta, D., Confuorto, M., Improta, G., & Marcelli, V. (2019) · Cited by 3 · see citing works
ЛІКУВАННЯ ПОСТТРАВМАТИЧНОГО СТРЕСОВОГО РОЗЛАДУ: ОГЛЯД КПТ ВТРУЧАНЬ НА ОСНОВІ ДОКАЗОВОЇ МЕДИЦИНИ
Mazur, O. V., Лемещук, М., Коваленко, І., Ордатій, Н. М., & Мацько, Н. (2023) · Наукові перспективи (Naukovì perspektivi) · doi:10.52058/2708-7530-2023-9(39)-600-612 · Cited by 2 · see citing works
Maffini, G., Peixoto, M. J. R., Cassel, P. A., & Abaid, J. L. W. (2021) · Psicologia e Saúde em Debate · doi:10.22289/2446-922x.v7n1a23 · Cited by 1 · see citing works
“…para o TEPT auxiliam o paciente a desenvolver suas próprias técnicas de enfrentamento, no manejo de sintomas e no ressignificar do trauma (Clark & Beck, 2012; Habigzang & Caminha, 2004; Knapp & Caminha, 2003; Macedo, Barbosa, Rodrigues, Coutinho, Figueira et al., 2018; Schneider & Habigzang, 2016).”
Rakowska, J. (2021) · Wydawnictwa Uniwersytetu Warszawskiego eBooks · doi:10.31338/uw.9788323547655
After Sexual Abuse or other Extreme Life Events
Wenzel, T. J., Chen, A. F., & Alksiri, R. (2023) · Springer eBooks · doi:10.1007/978-3-031-36864-6_8
Coletânea Ludovicense de Psicologia - Volume 5
Fernandes, M. A., Dias, E. S., Pereira, L. C. P., Reinaldo, M. D. S., & Muniz, K. V. F. (2024) · Editora Pascal LTDA eBooks · doi:10.29327/5414145
Interventions for reducing post-traumatic stress disorder symptoms among nurses: A systematic review
Park, J., Park, G., Lee, S., & Lee, H. (2026) · Nursing Outlook · doi:10.1016/j.outlook.2026.102906
- Authors
- Macedo, T., Barbosa, M., Rodrigues, H., Coutinho, E. D. S. F., Figueira, I., & Ventura, P.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Fiocruz, Brazil
- Venue
- Trends in Psychiatry and Psychotherapy
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2018-12
- Volume
- 40
- Issue
- 4
- Pages
- 352-359
- ISSN
- 2237-6089 (ISSN-L)
- 2238-0019
- OpenAlex
- W2904722179
- Cited by
- 14
- References
- 21
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 4 · 2019: 1
- FWCI
- 0.21
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Trends in Psychiatry and Psychotherapy (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- cognitive behavioral therapy, post-traumatic stress disorder, long-term treatment efficacy, maintenance of treatment effects, one-year follow-up, waitlist control, methodological limitations, psychotherapy outcome
- MeSH terms
- Humans, Stress Disorders, Post-Traumatic, Time Factors, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
