Supporting someone with PTSD: what the latest research says

A 2022 analysis of 78 studies, with 16,484 participants, estimated PTSD prevalence at 27% one month after trauma and 18% at three months. Later reductions were smaller. Most studies concerned a single identifiable traumatic event, and treatment received was not fully recorded, so this is not a clean measure of recovery without help [1]. An earlier review of 42 studies found that 44% of people with PTSD no longer met the criteria after an average of forty months without specific PTSD treatment, with wide differences between studies [2].

These findings are not a reason to wait before asking for help. The NHS advises seeing a GP if you think you have PTSD symptoms, or if treatment is not helping. If you are worried about someone else, encourage them to speak to their GP [3].

A review of 22 trials, which enrolled 2,638 people, found that average improvements after CBT-based PTSD treatments were generally maintained at follow-ups of at least a year. Only five studies extended beyond a year, and missing follow-up data limited the evidence [4].

In a Dutch study, 76% of 1,015 people with complete follow-up no longer met PTSD criteria after an eight-day programme, and 63% at six months. Many still had some symptoms. There was no comparison group, and 861 other people were excluded because follow-up data were missing. The percentages therefore may not represent everyone treated [5]. NICE says services should plan ongoing support for people with complex PTSD and additional needs [6]. Before the last session, ask what should happen if difficulties continue or return.

A 2021 review examined 139 studies measuring support and symptoms at one time and 37 following people over time. In these trauma-exposed community samples, more support was associated with fewer PTSD symptoms. Negative reactions had the strongest association among the types of support examined [7]. These are associations, not proof of cause.

A 2025 study of 173 female sexual-assault survivors linked a group of unsupportive reactions with more post-traumatic stress. Examples included taking control of decisions, urging someone to move on, and needing them to soothe your own distress [8]. The study did not establish which individual reaction mattered most. Let them make their own choices, and seek support elsewhere for your own anger or upset.

A study followed 151 recently trauma-exposed adults for a year. Reporting more support from friends than usual was associated with lower PTSD symptoms at the next assessment; worse symptoms also predicted less subsequent support [9]. A study of 272 US couples, each with a male service member and female civilian partner, found that increased PTSD symptoms predicted more partner accommodation, followed by more partner depression [10].

Accommodation means changes such as altering plans to help someone avoid distress, and is associated with more severe symptoms [11]. These studies do not show that partners caused PTSD or depression. Keep other support available, notice what you've given up, and discuss difficult patterns with their therapist if the person agrees.

In a US trial of 137 veterans with PTSD and their partners, a brief couple therapy called cognitive-behavioural conjoint therapy reduced PTSD more than PTSD education for couples, in an office or by video at home [12]. A 2019 Cochrane review found too few trials to be sure how much couple and family therapies help [13]. Routine UK access to the programme has not been verified for this article. NICE says information for families should cover how PTSD is treated [6]. If they'd like you involved, ask their therapist whether you could join a session.

A US study followed 7,308 World Trade Center responders for up to twenty years. Stressful events predicted later symptom increases, and symptoms predicted later stressful events. This suggests a possible reinforcing cycle, but cannot establish cause [14]. Among 2,942 people seen in US emergency departments after trauma, higher PTSD symptoms at three months were associated with more drinking at six months. The pattern varied by time and sex [15]. Offer practical help with pressures such as housing or work, and encourage them to mention changes in drinking to their care team. NICE says alcohol or drug misuse alone should not exclude someone from PTSD treatment [6].

In a study of 108 US soldiers treated for PTSD, 57% of those who no longer met PTSD criteria still reported insomnia symptoms and 13% reported nightmares [16]. A 2024 review of 24 trials found evidence that CBT for insomnia improved sleep quality and imagery rehearsal therapy reduced nightmares. Limited studies and mostly indirect comparisons make rankings between treatments uncertain [17]. Imagery rehearsal involves rewriting a recurring nightmare and practising the new version while awake [18]. If sleep remains difficult, ask the GP or therapist whether a treatment specifically for sleep would help.

Among 192 women in two trials of trauma-focused therapy, 15% to 29% experienced a temporary symptom increase, depending on the treatment. They still improved overall and were not more likely to leave treatment, although their final symptoms tended to be worse than those of participants without these increases [19]. A 2024 review found no evidence of worse average PTSD symptoms halfway through trauma-focused treatment than in comparison groups. It could not rule out earlier worsening or effects among people who dropped out [20].

Encourage them to tell the therapist if symptoms worsen, rather than assuming they must push through. NICE says trauma-focused CBT should include planning booster sessions around significant dates when needed [6]. Ask which anniversaries matter to them and what support they would like.

Some treatments begin with skills for managing emotions and relationships before working directly with traumatic memories. A 2025 review of four trials, with 356 adults who had experienced childhood trauma, did not establish an advantage for a separate preparatory phase. This small evidence base does not mean preparation is unnecessary for everyone [21]. Scotland's NHS guidance supports a flexible approach to individual needs and cautions against unnecessary delays; NICE says some people need extra time to build trust and address barriers to treatment [22][6].

A UK trial has completed its clinical phase, but full comparative results were not verified for this check [23]. Its registry records 117 participants, against the original plan for at least 350 [24][25]. If they've been told to wait, ask what preparation involves, how it will be reviewed and when trauma work might start.

A brief course of writing about trauma with a trained therapist. Two US trials found it met their criteria for being no worse than longer therapies on PTSD symptoms: one used five sessions in 126 adults, and the other five to seven sessions in 178 veterans. Fewer people left written exposure treatment: about 6% versus 40% in the first trial, and 13% versus 36% in the second [26][27]. These findings apply to the studied programmes and participants; this is not advice to write about trauma without support. Ask their therapist about suitable options and local availability.

A 2014 Oxford trial randomised 121 people to intensive cognitive therapy, weekly cognitive therapy, supportive therapy or a waiting list. At fourteen weeks, 73% in the intensive group and 77% in weekly cognitive therapy no longer met PTSD criteria, compared with 43% in supportive therapy and 7% on the waiting list [28]. Similar percentages in one trial do not prove the formats are interchangeable.

A 2025 NHS conference poster describes an intensive course for staff through an employee wellbeing service [29]. That is not a general public access route. If an intensive course is offered, ask what support will be available during and afterwards; lifts, childcare or meals may help them attend.

NICE conditionally recommends these therapist-supported programmes while more evidence is collected, subject to the required regulatory and NHS assessments [30]. In a UK trial of 217 adults, iCT-PTSD reduced symptoms more than online stress management [31]. In the Spring trial, 196 adults had mild to moderate PTSD linked to a single event. Spring met the study's criteria for being no worse than face-to-face treatment at sixteen weeks, but that comparison was inconclusive at one year [32].

Suitability needs a clinical assessment. NICE's recommendation for supported computerised trauma-focused CBT excludes people with severe PTSD symptoms, particularly dissociation, or risk of harm to themselves or others [6]. This is not a rule about every form of therapy delivered remotely. Adults in England can self-refer to NHS Talking Therapies to discuss suitable treatment [33].

A 2026 review of fourteen trials, with 1,119 participants, found a small to moderate improvement in PTSD symptoms with exercise, often alongside other care. Many trials had weaknesses. Its findings for yoga and strength training came from comparisons across different studies, rather than a reliable head-to-head test of which activity is best [34]. If they'd like to try an activity, offer company; it need not replace their treatment.

A guided procedure combines brief recall of an intrusive memory with playing Tetris in a particular way. In a 2026 trial with 99 NHS staff, the median number of intrusive memories in week four was 0.5, compared with 5 in each of two comparison groups [35]. This promising finding targets a particular symptom in a particular population; it does not show that ordinary Tetris play treats PTSD. The research team says the procedure remains a research intervention and playing the game alone is unlikely to help [36].

Op COURAGE supports veterans, service leavers and reservists in England, and can also support their families. Eligibility includes living in England, having served at least a full day in the UK armed forces, and being registered with a GP in England or willing and eligible to register. People still serving need a discharge date. The person or a family member can contact the service; they will need to provide their military service number [37].

Combat Stress runs a free 24-hour helpline on 0800 138 1619 and offers family support [38]. Veterans' NHS Wales accepts self-referrals for service-related mental health needs through its referral page; call 029 2183 2261 for help with the route. It is not an emergency service [39].

Next check due: 3 November 2026. Details to check: Service eligibility and contact details.