PTSD and the Social Support of the Interpersonal Environment: The Development of Social Cognitive Behavior Therapy

We will argue that, although the evidence for the effectiveness of cognitive-behavioral treatment, of PTSD is compelling, not all patients engage or respond to treatment and in those who do, residual symptomatology is not uncommon. We then briefly examine the literature on the influence of the interpersonal and emotional aspects of social support on the development, maintenance, and treatment of post-traumatic stress disorder (PTSD). Two areas of social support are suggested as potentially important to the study of PTSD: (1) the literature on expressed emotion (EE) and the underlying beliefs held by significant others which influence their negative coping behaviors and interactions with the patient, and (2) examination of the concept of reciprocity, the ability to receive and provide social support. Finally, we suggest a range of possible treatment options suggested by this review as possible adjuncts to conventional CBT. These include formal family interventions, re-engagement with social networks, and modification of perceptions of social interactions.