Key considerations for patient choice and development of alternatives

This commentary considers some of the issues raised by Rubenstein et al. (2024) using the framework of shared decision making and suggests next steps for research that will improve our ability to identify treatment approaches that will best support individual recovery. We highlight points of agreement with the authors, including the importance of treatment acceptability, but underscore the importance of simultaneously considering the strength of evidence for different treatments during shared decision making. Further research on emerging nontrauma-focused treatments for posttraumatic stress disorder is warranted, as is further research on adaptations and refinements to exposure therapy and trauma-focused treatment that demonstrate good clinical outcomes and acceptability. We also suggest that better assessment of trauma characteristics in clinical research may advance our understanding of prognostic treatment factors and our ability to predict which treatments will work best for which individuals with posttraumatic stress disorder and provide valuable information for the shared decision-making process. (PsycInfo Database Record (c) 2026 APA, all rights reserved)

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