Abstract
Many individuals with posttraumatic stress disorder (PTSD) continue to have substantial residual symptoms after completing psychological treatment. Well‐being therapy (WBT) has been developed to treat the residual phase of mental disorders, prevent relapse, and promote a full recovery. The present study aimed to compare treatment as usual (TAU) with the long‐term effects of WBT as a rehabilitation therapy in adults who successfully completed psychological treatment for PTSD. Participants who did not meet PTSD diagnostic criteria after completing treatment were randomized to WBT (n = 29) or TAU (n = 35) groups. Assessments of well‐being, residual PTSD symptoms, and posttraumatic growth were conducted at baseline (T0) and again after 3 months (T1), 6 months (T2), and 1 year (T3). The results of the multilevel analysis revealed that WBT was not more effective than TAU in increasing levels of well‐being, γ = 0.02 (SE = 0.11) or posttraumatic growth, γ = 0.10 (SE = 0.13) nor in decreasing PTSD symptoms, γ = −0.04 (SE = 0.05). However, for participants with low levels of well‐being at baseline (Mental Health Continuum‐Short Form score < 2.6), WBT was more effective than TAU in increasing ratings of well‐being, γ = −0.41 (SE = 0.19) and posttraumatic growth, γ = −0.55 (SE = 0.24); this effect was most evident at T3 for posttraumatic growth, d = 1.23. Future research should assess clinically relevant individual characteristics that to optimize the effectiveness and utility of WBT.
Highlights
Posttraumatic stress disorder (PTSD) is a complex and debilitating disorder that has been shown to have a lifetime prevalence of approximately 8% in the general population (Kessler et al, 2005)
The interaction between condition (WBT vs. treatment as usual (TAU)) and time was not significant. These outcomes did not support our expectations as Well-being therapy (WBT) was not associated with linear increases in well-being or posttraumatic growth (PTG) nor was it associated with linear decreases in PTSD symptoms during the study
The present study examined the short-term and follow-up effects of WBT compared to TAU with regards to promoting well-being and full recovery in patients who had previously completed treatment for PTSD
Summary
Posttraumatic stress disorder (PTSD) is a complex and debilitating disorder that has been shown to have a lifetime prevalence of approximately 8% in the general population (Kessler et al, 2005). Researchers have suggested that assessments of recovery and treatment response should consider levels of symptomatology and levels of well-being (Fava, Rafanelli, Cazzaro, Conti, & Grandi, 1998): Mental illness and wellbeing are related but separate continua (e.g., Keyes, 2002, 2005; Lamers, Westerhof, Bohlmeijer, ten Klooster, & Keyes, 2011) This means that individuals may experience various combinations of high and low levels of mental illness and well-being, Radstaak, Huning, & Bohlmeijer such as high levels of both, low levels of both, or a low level of one coupled with a high level of the other. It is possible that only interventions that facilitate progress toward restoration or enhancement of well-being can help a patient reach a full recovery (Fava et al, 1998)
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