Rapid Exposure Supporting Trauma Recovery - RESTORE

Prolonged exposure (PE) is the gold standard evidence based treatment for PTSD. It involves helping the person address the traumatic memories and avoided situations in a supportive, controlled and safe environment, in order to reduce the associated fear and modify interpretations of the event that are impeding recovery. Standard PE (SPE) requires weekly treatment for 10 weeks, which can pose a barrier to treatment uptake for some military personnel (for whom 10-week windows of availability between training activities, deployments and postings may be rare), as well as for veterans and other civilian populations (for whom life demands and stressors may make attendance difficult). Intensive PE (IPE) delivers the same intervention over 10 working days within a two week period, rather than weekly over 10 weeks. In this study we seek to test whether IPE is as effective as the 10-week SPE model. Both IPE and SPE sessions will be conducted individually with participants by psychologists. SPE consists of 10 weekly sessions of 90 minute, face-to-face manualised standard PE therapy with the therapist, and associated homework tasks. The IPE intervention is identical to SPE but delivered intensively over the course of two weeks, with a 90 minute session with the psychologist each morning, followed by homework tasks each afternoon. Homework is of approximately 2 hours duration, with tasks including gradually engaging in avoided situations, in imagination and in real-life. Participants do this in a gradual manner, while learning to manage the associated anxiety. Therapists will keep a session attendance log for each individual participant. Participants will keep a homework log which will be reviewed with their therapist at the beginning of each session.