Peer delivery of a brief cognitive-behavioral treatment for posttraumatic stress disorder: A hybrid effectiveness-implementation pilot study

Abstract

Objective: Posttraumatic stress disorder (PTSD) treatment delivery by peer specialist providers could increase access to and engagement with PTSD treatment in low resource settings. The current pilot study tested the feasibility, acceptability, and initial effectiveness of a peer-delivered, brief cognitive-behavioral therapy for PTSD.

Method: Four certified peer specialists delivered the intervention to 18 participants with probable PTSD. We assessed PTSD symptoms weekly and administered surveys and interviews at baseline and posttreatment.

Results: Our mixed-methods approach suggests that the intervention was feasible and acceptable, demonstrating high client satisfaction. We also found significant improvements in PTSD, depressive, anxiety, and general stress symptoms.

Conclusions: Peer-delivered interventions may be a good fit for addressing posttraumatic stress symptoms for people accessing care in low resource settings. Future research should evaluate peer-delivered PTSD treatment as a strategy for both reducing symptoms and improving access and engagement in professional care.

Keywords: acceptability; cognitive-behavioral therapy; feasibility; implementation science; mixed methods; peer delivery; posttraumatic stress disorder (PTSD); skills training; task-sharing; urban community.

Figure 1.

Flow chart of participant recruitment, attrition, and inclusion. PCL-5, Posttraumatic stress disorder Checklist for the DSM-5; LEC-5, Life Events Checklist for the DSM-5; STAIR-PC, Skills Training in Affective and Interpersonal Regulation for Primary Care.

Figure 2.

Changes in PTSD symptoms relative to baseline. PTSD, Posttraumatic stress disorder; PCL-5, PTSD Checklist for the DSM-5; S1, session 1; S2, session 2; S3, session 3; S4, session 4; S5, session 5; Post, post-assessment. * p<0.05 ** p<0.01