By Elliot Weiner, Ph.D., ABPP

At NYCBT, we often meet people who’ve been struggling with the effects of trauma for years. They may have been diagnosed with PTSD, or they may just know that something hasn’t felt right since that thing happened. They’ve tried talking about it, trying to “move on,” maybe even tried therapy—but nothing has really helped. And for many, that creates a painful belief: maybe nothing will.

But here’s the truth: PTSD is treatable. And not just in a “coping skills” kind of way. With the right therapy, most people experience real, meaningful symptom relief—and many no longer meet criteria for PTSD after treatment.

What Actually Works for PTSD?

There are a few therapies that have consistently outperformed others in the treatment of PTSD. These aren’t trends or “tools in a big toolbox”—they’re structured, trauma-focused approaches that have been tested in rigorous clinical trials and real-world settings alike.

Here are three that we use at NYCBT:

1. Cognitive Processing Therapy (CPT)

CPT helps people understand and shift the beliefs they’ve developed in the aftermath of trauma—beliefs about themselves, the world, and their role in what happened. Clients often come in thinking, “It was my fault,” or “I should’ve done more,” or “The world isn’t safe and never will be.” CPT helps untangle those painful thoughts in a structured, focused way.

It doesn’t involve going into the full details of the trauma, which makes it a great option for people who feel overwhelmed at the idea of revisiting what happened.

2. Prolonged Exposure (PE)

In contrast to CPT, PE is designed to help people gradually face the memories, places, and situations they’ve been avoiding. Not as a form of re-traumatization, but as a way to teach the brain: this memory can’t hurt me, and this place is actually safe now.

It’s hard work—and it’s also one of the most effective treatments we have for PTSD.

3. DBT-Prolonged Exposure (DBT-PE)

This approach combines trauma-focused exposure therapy with the emotion regulation and distress tolerance strategies from Dialectical Behavior Therapy (DBT). It’s especially helpful for clients with PTSD and significant difficulties with emotion dysregulation, impulsivity, or suicidality.

We often use DBT-PE when PTSD is part of a more complex clinical picture.

“But I’m Not a Veteran…”

Many people associate PTSD with military trauma, and yes—these treatments have been tested in VA hospitals and with combat veterans. But they’ve also been used successfully with survivors of sexual assault, childhood abuse, medical trauma, car accidents, and more.

If your nervous system still thinks it’s in danger—even though the trauma is in the past—then you deserve evidence-based care.

Coping Skills vs. Real Recovery

We’re all for coping skills. We teach them. We use them. And they can make a big difference in managing symptoms.

But if you’ve been stuck in a loop of managing, avoiding, and pushing through, it might be time for something more direct—something that addresses the heart of the trauma. Not just the symptoms around it.

A Note for Referring Clinicians

If you’re a therapist, psychiatrist, or primary care provider working with someone whose trauma history is getting in the way of progress, we’re happy to consult or collaborate. Our team at NYCBT includes therapists trained in CPT, PE, and DBT-PE, and we know how to tailor care to each client’s specific needs.

Because while trauma may be part of someone’s history, it doesn’t have to define their future.

Want to learn more or refer a client?
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