Stress Disorders, Post-Traumatic
Conditions
Keywords
Stress Disorders, Post-Traumatic, Psychotherapy, Mental Health, Veterans
Brief summary
Posttraumatic stress disorder (PTSD) is prevalent among Veterans and effective evidence-based psychotherapies (EBPs) for PTSD have been implemented within the Veterans Health Administration (VHA). However, retention in PTSD EBPs is poor. Premature dropout is associated with worse clinical outcomes and greater healthcare utilization. Delivery of PTSD EBPs in a massed format, typically three or more days per week delivered within a month, have shown promise for increasing retention. The present study is a pilot feasibility and acceptability study comparing massed PTSD treatment to treatment as usual (e.g., typically weekly treatment).
Interventions
OTHEREBP-Massed
CPT or PE will be delivered in a massed format (e.g., sessions at least 3 days per week)
OTHEREBP-TAU
CPT or PE will be delivered treatment as usual, which is typically once per week.
Sponsors
VA Office of Research and Development
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Clinical interviewers who assess primary outcomes will not be informed of participant's randomization assignment.
Intervention model description
Massed PTSD treatment (e.g., cognitive processing therapy \[CPT\] or prolonged exposure \[PE\] therapy delivered at least 3 times per week) will be compared to CPT & PE delivered as usual, which is usually once per week.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Veterans aged 18 years or older; * meets criteria for current PTSD; * willingness to be randomized to either condition (e.g., EBP-Massed or EBP-TAU); * decision to receive CPT or PE in a treatment planning session with a Durham Trauma Recovery Program clinic provider; * ability to provide informed consent
Exclusion criteria
* High acute suicide risk; * active manic symptoms that would likely interfere with treatment; * active psychotic symptoms that would likely interfere with treatment; * currently in a concurrent trauma-focused evidence-based treatment for PTSD
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment completion | Immediately after treatment completion or discontinuation (weeks 0-20) | Proportion of Veterans who complete a full course of an assigned PTSD treatment |
| Acceptability of Intervention (AIM) | Immediately after treatment completion or discontinuation (weeks 0-20) | Veterans' perceived acceptability of massed treatment for PTSD; scale score ranges from 1-5; greater score = greater acceptability |
| Client Satisfaction Questionnaire-8 (CSQ-8) | Post-treatment (weeks 0-20) | Veterans' perceived satisfaction of assigned treatment; range 8-32; greater scores = greater satisfaction |
| Clinician Administered PTSD Scale for DSM-5 (CAPS-5) Severity Score | Post-treatment (weeks 0-20) | PTSD Symptom Severity - Clinician Assessed; range 0-80; higher scores = greater severity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Health Questionnaire-9 (PHQ-9) | Post-treatment (weeks 0-20) | Self-reported depression; range = 0-27; higher scores = more severe symptoms |
| Brief Inventory of Psychosocial Functioning (BIPF) | Post-treatment (weeks 0-20) | PTSD-related psychosocial functioning; higher scores = more functional impairment. Items are scored on a Likert scale from 0 (never) to 6 (always). Participants are instructed to skip any item that does not reflect a domain that they have participated in over the past 30 days. The B-IPF is scored by summing the scored items to create a total score, dividing the total score by the maximum possible score based on the number of items scored, and multiplying by 100. |
| Session attendance | Post-treatment (weeks 0-20) | The number of sessions attended of the assigned treatment |
Countries
United States
Outcome results
None listed