Comparing psychotherapeutic approaches for posttraumatic stress disorder: Umbrella review evidence from cognitive behavioral therapy, acceptance and commitment therapy, and eye movement desensitization and reprocessing

This umbrella review evaluated the comparative effectiveness of Cognitive Behavioral Therapy (CBT) variants, EMDR therapy, and Acceptance and Commitment Therapy (ACT) in reducing PTSD among trauma survivors.

Article Abstract

“This umbrella review evaluated the comparative effectiveness of Cognitive Behavioral Therapy (CBT) variants, Eye Movement Desensitization and Reprocessing (EMDR), and Acceptance and Commitment Therapy (ACT) in reducing PostTraumatic Stress Disorder (PTSD) among trauma survivors. A systematic search guided by PRISMA guidelines identified 13 eligible systematic reviews, comprising six EMDR, four CBT variants, and three ACT-focused reviews. Across the included reviews, approximately 219 primary studies with a total of 15,169 participants were synthesized. Methodological quality and risk of bias were assessed using the Assessment of Multiple Systematic Reviews, and findings were narratively synthesized. Overall, all three interventions demonstrated efficacy in reducing PTSD symptoms, although the strength and consistency of evidence varied across modalities. CBT variants emerged as the most consistently supported interventions. ACT demonstrated promising outcomes, including moderate-to-large effect sizes across diverse trauma populations and brief intervention formats, although findings were less consistent due to heterogeneity in study designs and treatment protocols. EMDR was generally found to be comparable in effectiveness to CBT variants; however, results were mixed, with at least one review reporting no significant differences compared with control conditions. Despite methodological limitations across the evidence base, findings suggest that CBT variants, EMDR, and ACT are all effective interventions, with CBT variants demonstrating the strongest and most consistent support. Overall, the results support a flexible, individualized, and context-sensitive approach to PTSD treatment selection, while future research should prioritize rigorous comparative trials and standardized outcome measures.”

—Description from publisher

Article Access

Open Access

Rehman, S., Ghazali, S. R., & Elklit, A. (2026). Comparing psychotherapeutic approaches for posttraumatic stress disorder: Umbrella review evidence from cognitive behavioral therapy, acceptance and commitment therapy, and eye movement desensitization and reprocessing. International Journal of Psychology and Psychological Therapy, 26(3), 383-396. Retrieved from: https://www.ijpsy.com/volumen26/num3/719.html(opens in new tab)