Updated November 2026 · By Joel Blackstock, LICSW-S

The newer trauma therapies people ask about most are Brainspotting, Lifespan Integration, Internal Family Systems, Somatic Experiencing, neurofeedback, transcranial magnetic stimulation, and ketamine or MDMA given alongside psychotherapy. None of them yet has the trial record of trauma-focused CBT or EMDR. Several have small, encouraging studies. Ketamine’s PTSD results are mixed, and the FDA declined to approve MDMA in 2024.

The argument of this page is simple. When a therapy explains itself in the language of the brain, that explanation is a hypothesis, not a result. “Brain-based” describes the story a method tells about how it works; it says nothing yet about whether it works better than older treatments. The useful questions are how much evidence stands behind a method and whether it fits this particular person: how stable they are, how much they dissociate, what their trauma history looks like and what kind of work they are willing to do. Matching on those questions matters more than novelty.

An earlier version of this article presented these methods as established. It cited a Brainspotting study for a result the study does not report, two Lifespan Integration case studies that I could not find in Crossref or PubMed, a “prefrontal cortex” reference that turned out to be a paper about face perception, and a ketamine practice report on depression and anxiety scores as if it showed trauma memories being processed. It also used hypothetical client vignettes, which this version leaves out. This version keeps the topics and replaces the evidence. Taproot offers several of these methods, which is one more reason to describe them accurately.

Newer is not the same as better tested

Any honest comparison starts with the treatments that have the most evidence. The American Psychological Association’s 2019 PTSD guideline strongly recommends cognitive behavioral therapy, cognitive processing therapy, cognitive therapy and prolonged exposure, and conditionally recommends EMDR, brief eclectic psychotherapy and narrative exposure therapy.¹ The 2023 VA/DoD guideline recommends prolonged exposure, cognitive processing therapy or EMDR, and prefers manualized psychotherapy over medication.² A 2020 meta-analysis of 114 randomized trials with 8,171 participants found clinically important effects for trauma-focused CBT and for EMDR.³ I have written separately about whether EMDR is evidence-based, since it is the closest established relative of several methods below.

Those treatments still leave many people behind. In a JAMA review of randomized trials with military and veteran patients, 49% to 70% of people who received cognitive processing therapy or prolonged exposure improved meaningfully, yet roughly two-thirds still met criteria for PTSD at the end, and the authors called nonresponse rates high.⁴ A 2019 meta-analysis of 51 trials for complex PTSD symptoms found that CBT, exposure and EMDR beat usual care, but that people whose trauma began in childhood did less well.⁵

That gap is where the newer methods live. It is a real gap, and the people in it deserve options. But a shortfall in one treatment’s results is not evidence for another treatment. I find it useful to place the newer methods on four rungs:

• Replicated in many randomized trials: trauma-focused CBT and EMDR. Nothing else on this page has reached this rung for PTSD.
• Small randomized trials, often against waitlists or sham: Somatic Experiencing, trauma-informed yoga, neurofeedback and transcranial magnetic stimulation.
• Pilot studies, single cases and hypotheses: Brainspotting, Lifespan Integration, Internal Family Systems for PTSD, Process Work and Voice Dialogue.
• Drug-assisted treatments with mixed or disputed results: ketamine and MDMA, which belong with a prescriber, not with a therapist alone.

Being on a lower rung does not mean a method fails. It means nobody can yet say how often it helps, for whom, or compared with what. For the related question of why so many clients are moving toward body-based work anyway, see how somatic therapy compares with CBT for trauma.

Brainspotting and Lifespan Integration

Brainspotting

David Grand, a New York psychotherapist who trained in EMDR in the 1990s, says he developed Brainspotting in 2003. Its premise is that where you look affects how you feel. The therapist moves a pointer across the visual field to find an eye position where the client’s body activation around a memory is strongest, and the client holds attention there while that activation runs its course.⁶ Grand and Frank Corrigan later proposed that fixing the gaze engages a pathway from the retina through the superior colliculus to the pulvinar and the cingulate cortex, and that the healing happens in the midbrain. They presented these ideas as “testable hypotheses.”⁷ Little of that testing has been done.

The earlier version of this page said a 2018 study found a single Brainspotting session significantly reduced symptoms in 78% of subjects. I could not find that study. The study it cited, by Hildebrand, Grand and Stemmler, treated 76 adults with three 60-minute sessions of either EMDR (23 people) or Brainspotting (53 people). Both groups improved on self-reported PTSD symptoms, and the effect sizes were larger for EMDR (d = 1.19 to 1.76) than for Brainspotting (d = 0.74 to 1.04). The abstract does not describe random assignment, and the method’s developer is a coauthor.⁸ A 2022 study compared EMDR, Brainspotting, body-scan meditation and book reading in 40 psychologists and physicians in training, each working on distressing but not necessarily traumatic memories in single 40-minute sessions. EMDR and Brainspotting lowered distress ratings more than the other two conditions.⁹ That is a reasonable laboratory signal. It is not a PTSD trial.

None of this makes Brainspotting useless. It is a slow, attention-based way of staying with a memory and the body’s response to it, and a client who finds EMDR’s sets of eye movements too activating may prefer it. Offering it as an option is reasonable, provided the client knows the evidence is thin.

Lifespan Integration

Lifespan Integration (LI), developed by the therapist Peggy Pace, has the client call up a target memory and then move forward through a chronological series of brief memory cues, from that age to the present, repeated several times with the therapist guiding the client through the cues. The repetitions are meant to show the client, at a bodily level, that the event is over and that they have survived into the present.¹⁰ The earlier version linked this to the precuneus and to memories’ emotional “tags.” No study has tested that.

The published research is small. I found no randomized trial of the standard LI protocol for PTSD in PubMed. The closest is a Stockholm waitlist trial of a one-session modified protocol for women after a single sexual assault: among the 36 women analyzed, the treated group’s symptom scores fell by about half while the waitlist group’s did not change. Follow-up lasted three weeks, the lead author founded the nonprofit that runs the clinic, and the authors framed the finding as needing replication.¹¹ Most other LI studies are single-case designs, such as a 12-year-old treated in nine sessions over three months.¹² A 2023 Cochrane review of therapy for adult survivors of sexual assault listed LI among “new and emerging non-exposure based approaches” and called for head-to-head trials of such novel therapies with a year or more of follow-up.¹³ The two LI case studies the earlier version cited, one of them supposedly in a midwifery magazine, do not appear in Crossref or PubMed, so they are gone. Our guide to Lifespan Integration goes into the method in more detail.

Parts-based therapies: IFS, Process Work and Voice Dialogue

Internal Family Systems (IFS), which the family therapist Richard Schwartz began developing in the 1980s, treats the mind as a system of parts. In Schwartz’s model, exiles carry painful memories and feelings; managers try to keep the exiles out of awareness through control, perfectionism or self-criticism; and firefighters act fast when an exile breaks through, with bingeing, drinking, numbing or other emergency measures. Beneath the parts is the Self, a core of calm and curiosity from which the client can get to know each part and help it set down what it carries.¹⁴ Our history of Internal Family Systems traces how Schwartz arrived at the model.

IFS is popular, and its research is still at the pilot stage. A randomized pilot with 37 college women found that IFS and treatment as usual (CBT or interpersonal therapy) reduced depression about equally.¹⁵ An uncontrolled study of 17 adults with PTSD and multiple childhood traumas, each given sixteen 90-minute sessions, reported large drops in PTSD symptoms; there was no comparison group, and Schwartz was a coauthor.¹⁶ The first randomized trial of IFS for PTSD that I found, a 2026 feasibility study, assigned 60 adults to a 16-week online IFS group program or to an active comparison program with the same number of group and individual sessions. Both groups improved on clinician-rated PTSD symptoms, with no significant difference between them, although the IFS group attended more sessions and reported more satisfaction.¹⁷ The largest randomized trial of an IFS-based program I found was in rheumatoid arthritis, not trauma: 79 patients, with gains in pain and physical function after treatment, lasting improvement in joint pain, self-compassion and depressive symptoms a year later, and no sustained change in anxiety or disease activity.¹⁸ The earlier version stated that IFS “is effective” for PTSD, anxiety, depression, substance abuse and eating disorders. The trials do not yet support that list.

Two older relatives work similar ground. Process Work, or process-oriented psychology, grew out of Arnold Mindell’s effort to extend Jungian dream analysis to body symptoms, which he set out in Dreambody (1982).¹⁹ Voice Dialogue, developed by Hal Stone and Sidra Stone, has the client speak as different inner “selves,” such as a pleaser or a critic, while the facilitator talks with each in turn.²⁰ Both have long clinical traditions and almost no outcome research. A PubMed search turns up no controlled trial of either for trauma.

Clinically, parts language suits many people whose distress shows up as inner conflict: the part that wants to leave a relationship and the part that cannot. It can feel artificial to others. For people with marked dissociation, where parts may feel genuinely separate, pacing matters more than which parts model a therapist uses.

Somatic Experiencing and other body-based methods

Peter Levine built Somatic Experiencing (SE) partly on observing how animals come out of a freeze response once a threat has passed, and he described the approach for general readers in Waking the Tiger (1997). “Trauma is a fact of life,” he wrote there. “It does not, however, have to be a life sentence.”²¹ In session, SE works through sensation more than story. The therapist helps the client notice bodily sensations and impulses, touch distressing material in small doses (titration), and move back and forth between activation and settling (pendulation).²²

SE’s evidence is better than that of most methods on this page, and still modest. The first randomized trial gave 63 people with PTSD 15 weekly sessions or a place on a waitlist and found large improvements in PTSD symptoms and moderate to large improvements in depression.²³ A Danish trial in 91 people with chronic low back pain and PTSD found that adding SE to usual care reduced PTSD symptoms, though the authors questioned how clinically important the effect was,²⁴ but a later trial by the same group, in 114 patients, found no added benefit on any outcome.²⁵ A 2021 scoping review of 16 studies called the evidence preliminary and the study quality mixed.²⁶ Across body- and movement-oriented interventions for PTSD, a 2023 meta-analysis of 29 studies found a moderate average effect (g = 0.50) with very high heterogeneity, and judged only one study to be at low risk of bias.²⁷ Trauma-informed yoga has one of the stronger single trials in this group: among 64 women with chronic, treatment-resistant PTSD, 52% of the yoga group and 21% of a health-education group no longer met criteria after ten weekly classes.²⁸

SE asks a person to track sensation, and not everyone can do that at first. People who have trouble identifying and naming feelings, a trait called alexithymia, may need slower work on body awareness before body-focused processing helps. Our piece on understanding alexithymia describes what that looks like.

The earlier version also folded Rolfing (Ida Rolf’s Structural Integration), myofascial release and the claim that trauma is stored in the fascia into this family. I found no controlled trial of Rolfing or myofascial release for PTSD in PubMed, and I found no study testing the claim that trauma is stored in fascia. Bodywork may feel good, but it has not been shown to treat trauma.

Neurofeedback and brain stimulation

Neurofeedback trains a person to shift their own brain activity using real-time feedback from EEG sensors. The best-known PTSD trial randomized 52 adults with chronic PTSD to neurofeedback twice a week for 12 weeks or to a waitlist. Afterward, 27% of the neurofeedback group still met criteria for PTSD, compared with 68% of the waitlist group. Every participant received the same electrode placement; the protocol was not individualized from a brain map.²⁹

Meta-analyses agree on direction and disagree on confidence. A 2020 review of four randomized trials with 123 participants found results consistently favoring neurofeedback but rated the certainty of the evidence very low.³⁰ A 2023 review pooling seven randomized trials with 215 participants found a significant reduction in PTSD symptoms and noted that the studies were mostly small, heterogeneous and of varied quality.³¹ Waitlist comparisons cannot rule out expectation effects, and neurofeedback takes many sessions. QEEG brain mapping is often used to choose a protocol, but I found no randomized PTSD trial testing whether map-guided protocols do better than standard ones. Taproot offers brain mapping and neurofeedback; on this evidence it belongs alongside therapy as an adjunct, not in place of it.

Transcranial magnetic stimulation (TMS) uses magnetic pulses to stimulate the cortex, most often the dorsolateral prefrontal cortex. A 2020 meta-analysis of noninvasive brain stimulation for PTSD, with 11 randomized trials against sham or no stimulation in its quantitative analysis, found large reductions in core PTSD symptoms.³² A 2024 network meta-analysis of 21 trials with 981 patients found that several TMS and transcranial direct current stimulation protocols reduced PTSD symptoms at the end of treatment, but the effects were no longer significant at follow-up.³³ The FDA has cleared TMS devices for depression, obsessive-compulsive disorder, migraine and smoking cessation; a 2022 review of FDA milestones lists no clearance for PTSD.³⁴ For now, TMS for PTSD is off-label and best treated as experimental.

The earlier version said neuromodulation “likely works” by strengthening prefrontal emotion regulation and cited a 2011 study of biofeedback video games for children’s anxiety. That study does not address the mechanism. Its TMS citation, listed under the wrong first author, is a trial of TMS for depression after traumatic brain injury, not for PTSD.

Ketamine and MDMA with psychotherapy

Ketamine is an anesthetic that produces dissociation at lower doses. With psychotherapy, it is often marketed as a breakthrough for trauma, and the PTSD trials are more mixed than that. A 2021 trial in 30 adults with chronic PTSD found that six infusions over two weeks outperformed midazolam, an active placebo: 67% of the ketamine group responded, against 20%, although among responders the median time to losing that response was 27.5 days.³⁵ A larger 2022 trial in 158 veterans and service members found no significant effect on PTSD symptoms at either dose, though the standard dose improved depression.³⁶ A 2024 meta-analysis of six randomized trials with 221 participants found a small advantage over control that shrank and lost significance after correction for bias, with no meaningful difference by one to two weeks; its authors argue that participants’ ability to tell which drug they received is a serious problem.³⁷ The 2023 VA/DoD guideline suggests against ketamine for PTSD.³⁸

Ketamine-assisted psychotherapy, in which therapy sessions are built around the drug experience, has even less controlled data. A 2026 individual-participant meta-analysis of 12 studies with 533 participants found that more psychotherapy sessions went with more improvement, but nine of the studies were of poor quality, and in the higher-quality subset only baseline severity predicted outcome.³⁹ The earlier version said ketamine grows new neurons and opens a “window of plasticity” for rewriting trauma memories. What the mechanism research actually describes, largely in animals, is rapid strengthening of synapses linked to ketamine’s antidepressant effect.⁴⁰ How that relates to trauma memory in people is unknown.

There is a specific concern for trauma clients. Ketamine produces dose-related dissociative effects during treatment, which in the 2022 trial faded within two hours,³⁶ and a subgroup of people with PTSD already have a dissociative subtype marked by emotional shutdown rather than overactivation.⁴¹ I could not find a controlled ketamine trial in that group. Anyone considering ketamine should be screened for dissociation and should make the decision with a prescriber who knows their full history; questions about dosing or medication belong with that prescriber. Alabama’s rules on who may provide it are covered in our article on whether Alabama got rid of ketamine therapy for PTSD.

MDMA-assisted therapy reached a formal FDA review as a PTSD treatment. In the first of its phase 3 trials, published in 2021, 90 people with severe PTSD received MDMA or placebo within a manualized course of therapy that included three preparation and nine integration sessions, and the MDMA group improved substantially more (d = 0.91).⁴² In 2024 the FDA declined to approve it, citing potential safety risks and flaws in the research methods.⁴³ It remains investigational in the United States.

What this looks like in therapy

Choosing among these methods starts with assessment, not with whichever method a therapist happens to be trained in. These are the questions I find most useful:

• What kind of trauma, and how stable is the person now? A single recent event in an otherwise steady life and years of childhood abuse are different clinical problems. People in active crisis, unsafe relationships or heavy substance use usually need stabilization before memory-focused work of any brand.
• How much does the person dissociate? Screening matters for every method on this page, and especially before ketamine. The research on the dissociative subtype supports assessing for dissociation and treating it within stage-oriented care that builds stability before processing.⁴¹ Our dissociation therapy page describes how we approach this.
• What does the person want? Some people want to talk a memory through; others cannot yet put it into words. Across psychotherapy research, accommodating client preference is associated with fewer dropouts and somewhat better outcomes.⁴⁴ In PTSD trials about one in six people drop out, and dropout is higher in trauma-focused treatments.⁴⁵
• Is it working? A brief, validated self-report measure such as the PCL-5, repeated every few weeks, shows whether symptoms are actually moving.⁴⁶ If a newer method has not helped after a fair trial, the sensible next step is often one of the established treatments, not another new one.

Most of these methods are used in combination. A client might work on specific memories with EMDR or Brainspotting, use parts work for the self-criticism that keeps getting in the way, and use somatic work for a body that stays braced long after the danger has passed. That kind of integration is common in practice, and combinations like these are rarely studied as combinations. Clients deserve to hear that plainly.

If you are in the Birmingham area and trying to work out which of these approaches fits you, our overview of the treatments Taproot offers describes each one, and you can contact us to talk it through. Whoever you see, ask what the evidence says about the method they suggest, and how you will both know whether it is helping.

References

1. Guideline Development Panel for the Treatment of PTSD in Adults, American Psychological Association. (2019). Summary of the clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. American Psychologist, 74(5), 596–607. https://doi.org/10.1037/amp0000473
2. Schnurr, P. P., Hamblen, J. L., Wolf, J., Coller, R., Collie, C., Fuller, M. A., et al. (2024). The management of posttraumatic stress disorder and acute stress disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline. Annals of Internal Medicine, 177(3), 363–374. https://doi.org/10.7326/M23-2757
3. Lewis, C., Roberts, N. P., Andrew, M., Starling, E., & Bisson, J. I. (2020). Psychological therapies for post-traumatic stress disorder in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1), 1729633. https://doi.org/10.1080/20008198.2020.1729633
4. Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for military-related PTSD: A review of randomized clinical trials. JAMA, 314(5), 489–500. https://doi.org/10.1001/jama.2015.8370
5. Karatzias, T., Murphy, P., Cloitre, M., Bisson, J., Roberts, N., Shevlin, M., et al. (2019). Psychological interventions for ICD-11 complex PTSD symptoms: Systematic review and meta-analysis. Psychological Medicine, 49(11), 1761–1775. https://doi.org/10.1017/S0033291719000436
6. Grand, D. (2013). Brainspotting: The revolutionary new therapy for rapid and effective change. Sounds True. ISBN 9781604078909.
7. Corrigan, F., & Grand, D. (2013). Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation. Medical Hypotheses, 80(6), 759–766. https://doi.org/10.1016/j.mehy.2013.03.005
8. Hildebrand, A., Grand, D., & Stemmler, M. (2017). Brainspotting – the efficacy of a new therapy approach for the treatment of posttraumatic stress disorder in comparison to eye movement desensitization and reprocessing. Mediterranean Journal of Clinical Psychology, 5(1). https://doi.org/10.6092/2282-1619/2017.5.1376
9. D’Antoni, F., Matiz, A., Fabbro, F., & Crescentini, C. (2022). Psychotherapeutic techniques for distressing memories: A comparative study between EMDR, brainspotting, and body scan meditation. International Journal of Environmental Research and Public Health, 19(3), 1142. https://doi.org/10.3390/ijerph19031142
10. Pace, P. (2015). Lifespan Integration: Connecting ego states through time. Eirene Imprint. ISBN 9780976060369.
11. Rajan, G., Wachtler, C., Lee, S., Wändell, P., Philips, B., Wahlström, L., et al. (2022). A one-session treatment of PTSD after single sexual assault trauma. A pilot study of the WONSA MLI project: A randomized controlled trial. Journal of Interpersonal Violence, 37(9–10), NP6582–NP6603. https://doi.org/10.1177/0886260520965973
12. Rensch, C., Kwee, J., Rossen, L., & McDonald, M. (2021). Lifespan Integration therapy with trauma-exposed children: A hermeneutic single case efficacy study. Journal of Child & Adolescent Trauma, 14(3), 401–413. https://doi.org/10.1007/s40653-021-00359-9
13. O’Doherty, L., Whelan, M., Carter, G. J., Brown, K., Tarzia, L., Hegarty, K., et al. (2023). Psychosocial interventions for survivors of rape and sexual assault experienced during adulthood. Cochrane Database of Systematic Reviews, 2023(10), CD013456. https://doi.org/10.1002/14651858.CD013456.pub2
14. Schwartz, R. C., & Sweezy, M. (2019). Internal family systems therapy (2nd ed.). Guilford Press. ISBN 9781462541461.
15. Haddock, S. A., Weiler, L. M., Trump, L. J., & Henry, K. L. (2017). The efficacy of internal family systems therapy in the treatment of depression among female college students: A pilot study. Journal of Marital and Family Therapy, 43(1), 131–144. https://doi.org/10.1111/jmft.12184
16. Hodgdon, H. B., Anderson, F. G., Southwell, E., Hrubec, W., & Schwartz, R. (2022). Internal family systems (IFS) therapy for posttraumatic stress disorder (PTSD) among survivors of multiple childhood trauma: A pilot effectiveness study. Journal of Aggression, Maltreatment & Trauma, 31(1), 22–43. https://doi.org/10.1080/10926771.2021.2013375
17. Joss, D., Comeau, A., Chevannes, R., Parry, G., Rea, H. S., Barria, J., et al. (2026). A randomized controlled trial of an online group-based internal family systems treatment for posttraumatic stress disorder: The Program for Alleviating and Resolving Trauma and Stress (PARTS) study. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://doi.org/10.1037/tra0002089
18. Shadick, N. A., Sowell, N. F., Frits, M. L., Hoffman, S. M., Hartz, S. A., Booth, F. D., et al. (2013). A randomized controlled trial of an internal family systems-based psychotherapeutic intervention on outcomes in rheumatoid arthritis: A proof-of-concept study. The Journal of Rheumatology, 40(11), 1831–1841. https://doi.org/10.3899/jrheum.121465
19. Mindell, A. (1982). Dreambody: The body’s role in revealing the self. Sigo Press.
20. Stone, H., & Winkelman, S. (1989). Embracing our selves: The voice dialogue manual. New World Library. (Original work published 1985)
21. Levine, P. A., & Frederick, A. (1997). Waking the tiger: Healing trauma. North Atlantic Books. ISBN 155643233X.
22. Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93. https://doi.org/10.3389/fpsyg.2015.00093
23. Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic experiencing for posttraumatic stress disorder: A randomized controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312. https://doi.org/10.1002/jts.22189
24. Andersen, T. E., Lahav, Y., Ellegaard, H., & Manniche, C. (2017). A randomized controlled trial of brief somatic experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms. European Journal of Psychotraumatology, 8(1), 1331108. https://doi.org/10.1080/20008198.2017.1331108
25. Andersen, T. E., Ellegaard, H., Schiøttz-Christensen, B., Mejldal, A., & Manniche, C. (2020). Somatic experiencing for patients with low back pain and comorbid posttraumatic stress symptoms: A randomised controlled trial. European Journal of Psychotraumatology, 11(1), 1797306. https://doi.org/10.1080/20008198.2020.1797306
26. Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing: Effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology, 12(1), 1929023. https://doi.org/10.1080/20008198.2021.1929023
27. van de Kamp, M. M., Scheffers, M., Emck, C., Fokker, T. J., Hatzmann, J., Cuijpers, P., & Beek, P. J. (2023). Body- and movement-oriented interventions for posttraumatic stress disorder: An updated systematic review and meta-analysis. Journal of Traumatic Stress, 36(5), 835–848. https://doi.org/10.1002/jts.22968
28. van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. The Journal of Clinical Psychiatry, 75(6), e559–e565. https://doi.org/10.4088/JCP.13m08561
29. van der Kolk, B. A., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016). A randomized controlled study of neurofeedback for chronic PTSD. PLOS ONE, 11(12), e0166752. https://doi.org/10.1371/journal.pone.0166752
30. Steingrimsson, S., Bilonic, G., Ekelund, A.-C., Larson, T., Stadig, I., Svensson, M., et al. (2020). Electroencephalography-based neurofeedback as treatment for post-traumatic stress disorder: A systematic review and meta-analysis. European Psychiatry, 63(1), e7. https://doi.org/10.1192/j.eurpsy.2019.7
31. Askovic, M., Soh, N., Elhindi, J., & Harris, A. W. F. (2023). Neurofeedback for post-traumatic stress disorder: Systematic review and meta-analysis of clinical and neurophysiological outcomes. European Journal of Psychotraumatology, 14(2), 2257435. https://doi.org/10.1080/20008066.2023.2257435
32. Kan, R. L. D., Zhang, B. B. B., Zhang, J. J. Q., & Kranz, G. S. (2020). Non-invasive brain stimulation for posttraumatic stress disorder: A systematic review and meta-analysis. Translational Psychiatry, 10(1), 168. https://doi.org/10.1038/s41398-020-0851-5
33. Liu, H., Wang, X., Gong, T., Xu, S., Zhang, J., Yan, L., et al. (2024). Neuromodulation treatments for post-traumatic stress disorder: A systematic review and network meta-analysis covering efficacy, acceptability, and follow-up effects. Journal of Anxiety Disorders, 106, 102912. https://doi.org/10.1016/j.janxdis.2024.102912
34. Cohen, S. L., Bikson, M., Badran, B. W., & George, M. S. (2022). A visual and narrative timeline of US FDA milestones for transcranial magnetic stimulation (TMS) devices. Brain Stimulation, 15(1), 73–75. https://doi.org/10.1016/j.brs.2021.11.010
35. Feder, A., Costi, S., Rutter, S. B., Collins, A. B., Govindarajulu, U., Jha, M. K., et al. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. American Journal of Psychiatry, 178(2), 193–202. https://doi.org/10.1176/appi.ajp.2020.20050596
36. Abdallah, C. G., Roache, J. D., Gueorguieva, R., Averill, L. A., Young-McCaughan, S., Shiroma, P. R., et al. (2022). Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military: A double-blind, randomized, placebo-controlled multi-center clinical trial. Neuropsychopharmacology, 47(8), 1574–1581. https://doi.org/10.1038/s41386-022-01266-9
37. Borgogna, N. C., Owen, T., Vaughn, J., Johnson, D. A. L., Aita, S. L., & Hill, B. D. (2024). So how special is special K? A systematic review and meta-analysis of ketamine for PTSD RCTs. European Journal of Psychotraumatology, 15(1), 2299124. https://doi.org/10.1080/20008066.2023.2299124
38. Barbara, A. M., Xie, W., Mahood, Q., & Hamson, A. (2024). Ketamine for adults with treatment-resistant depression or posttraumatic stress disorder: A 2023 update. Canadian Journal of Health Technologies, 4(1). (Quotes the 2023 VA/DoD PTSD guideline recommendation on ketamine.) https://doi.org/10.51731/cjht.2024.817
39. Rohde, J., Moore, T. M., Walker, K., Ahmed, S. S., MacConnel, H. A., Krsak, M., et al. (2026). Ketamine-assisted psychotherapy for posttraumatic stress disorder: A systematic review and individual participant data meta-analysis of predictors of treatment effects. Psychotherapy and Psychosomatics. Advance online publication. https://doi.org/10.1159/000553144
40. Zanos, P., & Gould, T. D. (2018). Mechanisms of ketamine action as an antidepressant. Molecular Psychiatry, 23(4), 801–811. https://doi.org/10.1038/mp.2017.255
41. Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. American Journal of Psychiatry, 167(6), 640–647. https://doi.org/10.1176/appi.ajp.2009.09081168
42. Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., et al. (2021). MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27(6), 1025–1033. https://doi.org/10.1038/s41591-021-01336-3
43. Roush, K. (2024). FDA denies approval of MDMA-assisted therapy for PTSD. AJN, American Journal of Nursing, 124(11), 14. https://doi.org/10.1097/01.NAJ.0001081684.80872.ce
44. Swift, J. K., Callahan, J. L., Cooper, M., & Parkin, S. R. (2018). The impact of accommodating client preference in psychotherapy: A meta-analysis. Journal of Clinical Psychology, 74(11), 1924–1937. https://doi.org/10.1002/jclp.22680
45. Lewis, C., Roberts, N. P., Gibson, S., & Bisson, J. I. (2020). Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1), 1709709. https://doi.org/10.1080/20008198.2019.1709709
46. Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059