Assessing and Addressing Functioning and Quality of Life in PTSD

Purpose of review Arguably, the most important goal of psychotherapy is to improve patients’ functioning and quality of life (QoL). Because the field of post-traumatic stress disorder (PTSD) has been driven by the disease model, outcomes are solely indexed by symptom change. We review the barriers to assessing functioning and QoL in PTSD and examine the available evidence that evidence-based treatments for PTSD that focus on symptom change address functioning and QoL. Recent findings Assessments of functioning and QoL are limited because current methods are nomothetic and fail to capture the breadth and depth of functioning (while still being feasible to implement in routine practice). Notwithstanding this limitation, cognitive processing and prolonged exposure therapies are not superior to other treatments in improving functioning and QoL. Summary Clinicians and clinical researchers should attend to functioning and QoL to plan treatment and track change. Ideally, assessments of functioning and QoL require an idiographic approach that identifies unique domains of functional problems. In contrast to the disease model, a recovery-oriented framework is better suited to advance knowledge about treatment-valid assessment approaches in PTSD.