Exposure counterconditioning (EC) as a treatment for severe PTSD and depression with an illustrative case

Cognitive behavioral therapies have strong empirical support as the treatme nts of choice for PTSD. Still, a significant proportion of the patients ret ain distressing PTSD symptoms after treatment. A treatment named Exposure C ounterconditioning (EC), based on Wolpe's (1995, Theories of behaviour ther apy (pp. 23-57). Washington, DC: American Psychological Association) recipr ocal inhibition theory and Pavlovian conditioning mechanisms (Baldwin & Bal dwin, 1986, Behavior principles in everyday life (pp. 41-42). New Jersey: P rentice-Hall) is presented. The EC treatment is proposed as an addition to the established treatments for PTSD. A case study from which the EC treatme nt was first developed is illustrated. The patient suffered from severe PTS D and depression. The EC treatment was effective in eliminating the patient 's PTSD and depression. Also, the patient's severe anger guilt and dissocia tion were eliminated. The results and important clinical observations are d iscussed within an counterconditioning framework. (C) 1999 Elsevier Science Ltd. All rights reserved.