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PTSD Treatment Response — MRCPsych Paper B MCQ

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ModerateAnxiety & Stress-Related DisordersPTSD Treatment ResponseMRCPsych Paper B

An adult with established post-traumatic stress disorder is about to start individual trauma-focused cognitive behavioural therapy and asks when the response to treatment should be assessed. Which is the most accurate advice?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Review response throughout a course of 8–12 sessions, extending treatment when clinically indicated.

The correct answer is C. NICE recommends manualised individual trauma-focused CBT for established adult PTSD, typically over 8–12 sessions, with additional sessions when clinically indicated. It does not define a universal session by which improvement must begin, so symptoms and functioning should be reviewed throughout treatment. The original claim that meaningful improvement should begin specifically by sessions 4–6 is too prescriptive and is not directly supported by NG116. One session is insufficient to judge the intervention, and NICE specifies no automatic session-4 stopping rule. Waiting 12 months before assessment would delay appropriate review. Trauma-focused CBT is therapeutic, not merely preventive, and is a recommended first-line psychological treatment for adults with PTSD.

Reference: National Institute for Health and Care Excellence. Post-traumatic stress disorder (NG116), recommendations 1.6.16–1.6.17. 2018. https://www.nice.org.uk/guidance/ng116/chapter/recommendations