Traumatology

 

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Traumatology, Vol. 12, No. 1, 83-99 (2006)
DOI: 10.1177/153476560601200106

The Counting Method: Applying the Rule of Parsimony to the Treatment of Posttraumatic Stress Disorder

David Read Johnson

Hadar Lubin

Post Traumatic Stress Center, 19 Edwards Street, New Haven, Connecticut 06511 and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, ptsdcenter{at}sbcglobal.net

The authors contend that the primary therapeutic element in psychological treatments for posttraumatic stress disorder is imaginal exposure, and that differences among major approaches are determined more by secondary techniques designed to circumvent the client’s avoidant defenses against exposure. A study is described comparing Prolonged Exposure, Eye Movement Desensitization and Reprocessing, and the Counting Method with 51 multiply-traumatized women. Measures of PTSD were significantly reduced by all three methods, but differences among the methods were negligible. Because the Counting Method utilizes only imaginal exposure as a therapeutic element, support is given to the more parsimonious conclusion that imaginal exposure may be both the necessary and sufficient factor in therapeutic effect, countering a trend in the field toward more complex, multi-faceted treatment packages.

Key Words: Brief treatment • PTSD • women • imaginal exposure • counting method


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