prolonged exposure for ptsd: innovations to improve access, engagement, and outcomes

This book aims to reconcile a disconnect in the field of trauma psychology: On one hand, decades of accumulated evidence support the safety and efficacy of prolonged exposure therapy (PE) for posttraumatic stress disorder (PTSD). On the other hand, many individuals suffering from PTSD cannot access PE. Even among individuals who begin PE, many experience challenges in completing a full course of treatment. Further, PTSD is a complex and heterogenous disorder; not all individuals who complete PE experience a meaningful benefit. PE is an evidence-based psychological treatment that helps individuals approach situations and memories related to their trauma so that they learn to think differently about the trauma and no longer experience intense distress when confronted with trauma reminders. This book is designed for clinicians and researchers who share the goal of increasing the reach and impact of evidence-based treatment for individuals with PTSD. Each chapter synthesizes the latest research findings and provides clear clinical guidance to inform adaptations to improve access, engagement, and clinical outcomes for PE.

Obtaining the best outcomes with prolonged exposure requires not only trained and skilled clinicians-it requires clinicians who have the ability to adapt, enhance, and tailor it for individual patients and settings. This should be a required textbook for all students and trainees in the area of psychological trauma.

Alan L. Peterson, PhD, ABPP

The first book of this type, the authors have provided valuable new information and summarized succinctly the academic literature that is the underpinning of the success of this approach to psychological care. It is both a comprehensive and essential book for all those interested in treating and studying trauma survivors.

Terry Keane, PhD

This book is... timely, including telemental health, intensive delivery formats, digital interventions, and virtual reality. Clinicians and researchers will find it invaluable.

Barbara Olasov Rothbaum, PhD, ABPP

Dr. Carmen McLean is a licensed clinical psychologist and researcher with the Dissemination and Training Division of the National Center for PTSD at the Palo Alto VA Health Care System and a Clinical Professor (Affiliate) at the Department of Psychiatry and Behavioral Sciences at Stanford University. Her research examines ways to increase the reach of exposure therapy for PTSD by addressing implementation barriers and testing digital exposure-based interventions, with the goal of helping more individuals with PTSD benefit from effective treatment. Dr. McLean is currently leading three clinical trials testing written exposure therapy for PTSD with firefighters and military personnel using novel treatment formats and delivery strategies. Dr. McLean was the 2018 recipient of the Anne Marie Albano Early Career Award for Excellence in the Integration of Science and Practice from the Association for Cognitive and Behavioral Therapies and the 2023 recipient of the APA Division 56 Award for Outstanding Contributions to the Practice of Trauma Psychology. She co-authored the book Retraining the Brain: Applied Neuroscience in Exposure Therapy for PTSD with Dr. Sheila Rauch. Dr. McLean is currently serving on the APA Clinical Practice Guideline Panel for the Treatment of PTSD and is the Editor-elect for the journal Cognitive and Behavioral Practice.

Dr. Elizabeth Goetter is a licensed clinical psychologist, Associate Professor, and Director of the Psychology Doctoral Program at La Salle University. She serves as a clinical consultant at Massachusetts General Hospital (MGH) where she previously served as Senior Clinical Director at MGH Home Base and was the co-clinical director of psychology. Dr. Goetter’s clinical and research interests include the efficacy, dissemination, and utilization of empirically supported treatments for traumatic stress disorders, particularly among military and veteran populations. She has served as a study therapist and assessor on multiple externally-funded studies and co-authored manuscripts and book chapters on issues pertaining to posttraumatic stress disorder, anxiety disorders, grief, veteran mental health, technology and telehealth approaches to treatment, barriers to treatment, and treatment utilization and dropout. She is an Associate Editor for the International Journal of Mental Health and also serves as an editorial board member for Cognitive and Behavioral Practice and the European Journal of Psychotraumatology.