The PACT Model: Improving Outcomes in the Treatment of PTSD

Abstract

This article introduces a new model for the treatment of posttraumatic stress disorder that has the potential to provide clinicians with information that may facilitate improved outcomes. The PACT model emerged during a systematic literature review intended to suggest ways to enhance the efficacy of evidence-based treatments by critically evaluating the potential mechanisms of therapeutic action at work in a novel treatment approach, MDMA (3,4-Methylenedioxymethamphetamine)-assisted psychotherapy, and applying this understanding to existing treatment protocols. The goal of the review was to synthesize the potential therapeutic mechanisms of action that are involved in this approach, and to better understand how they could inform other protocols without the need to administer MDMA. Four elements of MDMA-assisted psychotherapy that do not require the administration of MDMA and could inform our approach to treating patients with trauma form the basis of the PACT model: (1) Presence; (2) Acceptance; (3) Connection; (4) Transcendence. This article highlights how the PACT model reflects the qualities and values of humanistic–existential therapies, explains how it overlaps with and extends common factors in psychotherapy, and suggests how these four elements may signify important avenues of future research for trauma treatments, focusing on enhancing the patient’s experience of safety and posttraumatic growth.