Brief treatment for PTSD: A non-inferiority trial

Abstract

Prior studies have identified several psychosocial treatment approaches as effective for posttraumatic stress disorder (PTSD). Unfortunately, a substantial minority of individuals who receive these treatments drop out prematurely. Moreover, a considerable number of individuals in need of PTSD treatment do not present for treatment due to time constraints and other barriers to care. Thus, there is a need to develop alternative evidence-based PTSD treatments that have lower treatment dropout rates and address current barriers to receiving care. One recently developed PTSD treatment that has demonstrated efficacy and potentially meets these criteria is Written Exposure Therapy (WET), a 5-session treatment protocol that promotes recovery through writing about the trauma event as well as one's thoughts and feelings about it without any assigned homework. In an ongoing randomized controlled trial (RCT) we are investigating whether WET is equally efficacious as Cognitive Processing Therapy (CPT), a treatment that typically requires more therapist training and more therapy sessions. The study sample consists of 126 adults diagnosed with PTSD who are randomly assigned to either WET (n=63) or CPT (n=63). Participants are assessed prior to treatment and 6-, 12-, 24-, 36-, and 60-weeks after the first treatment session. The primary outcome measure is PTSD symptom severity assessed with the Clinician Administered PTSD Scale for DSM-5. Given the prevalence of PTSD and the aforementioned limitations of currently available first-line PTSD treatments, the identification of a brief, efficacious treatment that is associated with reduced patient dropout would represent a significant public health development.

Keywords: Clinical trial; Cognitive behavioral therapy; Posttraumatic stress disorder.

Fig. 1

Planned participant flow.