None listed
Conditions
Brief summary
People in high-risk occupations, such as those in emergency service organizations, are at high risk of psychological disorders. Posttraumatic stress disorder (PTSD) is the most common psychiatric disorder that develops following exposure to a traumatic event, and emergency service personnel have markedly higher rates of PTSD. PTSD is characterised by severe and persistent stress reactions including: intrusive memories and nightmares of the trauma, hypervigilance, difficulty sleeping, emotional withdrawal, pervasive negative emotions, and avoidance of places, activities, and situations that are reminiscent of their trauma. The treatment of choice for posttraumatic stress disorder (PTSD) is trauma-focused psychotherapy. Trauma-focused psychotherapy typically commences with psychoeducation about the trauma responses, and then focuses on three major strategies: anxiety management, exposure, and cognitive restructuring. Despite support for this therapeutic approach, meta-analyses indicate that at least one-third of patients do not respond to this treatment. This situation is also evidence in treatment of PTSD in emergency service personnel. One recent advance has shown that training people to focus attention in a more controlled way can promote reduction of PTSD symptoms. Accordingly, this trial aims to augment TF-CBT for PTSD by comparing standard TF-CBT with TF-CBT combined with attention training. It is hypothesized that the augmented TF-CBT that includes attention training will result in greater reduction of PTSD than standard TF-CBT.
Interventions
There are two arms to this trial that were designed specifically for this trial. Arm 1 (intervention): Augmented Cognitive Behaviour Therapy. Arm 2 (comparator): Cognitive Behaviour Therapy. Augmented Cognitive Behaviour Therapy is administered on an individual basis on a once-weekly basis by a clinical psychologist either face-to-face or remotely via Zoom. Therapy comprises individual 60-minute sessions administered over 12 weeks. The intervention instructs participants on the following stress
There are two arms to this trial that were designed specifically for this trial. Arm 1 (intervention): Augmented Cognitive Behaviour Therapy. Arm 2 (comparator): Cognitive Behaviour Therapy. Augmented Cognitive Behaviour Therapy is administered on an individual basis on a once-weekly basis by a clinical psychologist either face-to-face or remotely via Zoom. Therapy comprises individual 60-minute sessions administered over 12 weeks. The intervention instructs participants on the following stress coping strategies: psychoeducation, anxiety reduction, exposure to trauma memories, and discussion of trauma memories, and relapse prevention. In the first 4 sessions of treatment, participants will also complete a 10-minute computer task in which they use their mouse to indicate the position of threat or neutral stimuli on the computer screen. Treatment adherence will be assessed by checklist completed by therapists. The duration of the study for any participant will conclude after a 2-year follow-up assessment, resulting in participation duration of 125 weeks.
Sponsors
UNSW Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Meet criteria for PTSD as defined by DSM-5 Aged at least 18 years Current or former member of Emergency Service Personnel Sufficient English proficiency
Exclusion criteria
Current psychosis Imminent suicidal risk Current substance dependence
Outcome results
None listed