A comparison of cognitive and exposure-oriented trauma therapies in improving quality of life: a meta-analysis.

Prior meta-analyses have demonstrated that psychotherapies for posttraumatic stress disorder (PTSD) have small to medium impacts in improving quality of life (QOL); however, they have not determined whether there are QOL differences between two major types of PTSD psychotherapies, cognitive-oriented therapies (CT) versus exposure-oriented therapies (ET). As such, the aim of this meta-analysis was to explore whether CTs versus ETs differentially impact QOL. A search was conducted through the PTSD Trials Standardized Data Repository and similar meta-analyses to identify randomized controlled trials of PTSD psychotherapies that included a QOL measure. This search yielded a total of 47 eligible studies. Results indicated that there was no statistically significant difference between CTs and ETs in impacting QOL, and regardless of therapy posttreatment gains in QOL diminished over extended follow-up. Overall, both CTs and ETs may help to improve QOL, but adaptations or new interventions may be needed to produce a more lasting impact.