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Application of Cognitive-Behavioral Treatment for Long-Standing Posttraumatic Stress Disorder in Law Enforcement Personnel

The development and maintenance of posttraumatic stress disorder (PTSD) can be understood as a function of learning and cognitive processes. This case report addresses treatment of PTSD with a 72-year-old former police officer who was experiencing intrusive thoughts, nightmares, experiential and affective avoidance, and hyperarousal resulting from witnessing a series of traumatic events during his time in law enforcement. Although the latency between events and treatment was more than 20 years, this patient was responsive to a cognitive-behavioral, exposure-based treatment. Several other factors, including the client's age and chronic pain, complicated this case. The aim of this study was to identify the conceptual framework for treatment, explore the course of therapy, and identify socially valid means of treatment and assessment in outpatient therapy. At the termination of treatment, this patient evidenced improvements in overall anxiety, depressive symptoms, and frequency and severity of PTSD symptoms. Recommendations for clinicians and treatment implications are also presented.