Design of a randomized superiority trial of a brief couple treatment for PTSD - PubMed (original) (raw)

doi: 10.1016/j.conctc.2019.100369. eCollection 2019 Sep.

Alexandra Macdonald 3, Kathleen M Grubbs 1 2, Margaret-Anne Mackintosh 4, Candice M Monson 5, Lisa H Glassman 1 2, Julia Becker 6 7, Frederic Sautter 7, Brian Buzzella 1 2, Elizabeth Wrape 1 2, Stephanie Y Wells 1 8, Benjamin M Rooney 1, Shirley Glynn 9 10

Affiliations

Design of a randomized superiority trial of a brief couple treatment for PTSD

Leslie A Morland et al. Contemp Clin Trials Commun. 2019.

Abstract

Interpersonal difficulties are common among veterans with posttraumatic stress disorder (PTSD) and are associated with poorer treatment response. Treatment outcomes for PTSD, including relationship functioning, improve when partners are included and engaged in the therapy process. Cognitive-behavioral conjoint therapy for PTSD (CBCT) is a manualized 15-session intervention designed for couples in which one partner has PTSD. CBCT was developed specifically to treat PTSD, engage a partner in treatment, and improve interpersonal functioning. However, recent research suggests that an abbreviated CBCT protocol may lead to sufficient gains in PTSD and relationship functioning, and yield lower dropout rates. Likewise, many veterans report a preference for receiving psychological treatments through clinical videoteleconferencing (CVT) rather than traditional face-to-face modalities that require travel to VA clinics. This manuscript describes the development and implementation of a novel randomized controlled trial (RCT) that examines the efficacy of an abbreviated 8-session version of CBCT ("brief CBCT," or B-CBCT), and compares the efficacy of this intervention delivered via CVT to traditional in-person platforms. Veterans and their partners were randomized to receive B-CBCT in a traditional Veterans Affairs office-based setting (B-CBCT-Office), CBCT through CVT with the veteran and partner at home (B-CBCT-Home), or an in office-delivered, couple-based psychoeducation control condition (PTSD Family Education). This study is the first RCT designed to investigate the delivery of B-CBCT specifically to veterans with PTSD and their partners, as well as to examine the delivery of B-CBCT over a CVT modality; findings could increase access to care to veterans with PTSD and their partners.

Keywords: Cognitive behavioral conjoint therapy; Couple therapy; Home-based care; Randomized controlled trial; Veterans; Videoconferencing.

PubMed Disclaimer

Figures

Fig. 1

Fig. 1

Study design diagram and hypothesis testing algorithm.

References

    1. Marmar C.R., Schlenger W., Henn-Haase C., Qian M., Purchia E., Li M., Corry N., Williams C.S., Ho C.-L., Horesh D., Karstoft K.-I., Shalev A., Kulka R.A. Course of posttraumatic stress disorder 40 years after the Vietnam war: findings from the national Vietnam veterans longitudinal study. JAMA Psychiatry. 2015;72(9):875–881. -PubMed
    1. Elhai J.D., Contractor A.A., Palmieri P.A., Forbes D., Richardson J.D. Exploring the relationship between underlying dimensions of posttraumatic stress disorder and depression in a national, trauma-exposed military sample. J. Affect. Disord. 2011;133(3):477–480. -PubMed
    1. Smith M.W., Schnurr P.P., Rosenheck R.A. Employment outcomes and PTSD symptom severity. Ment. Health Serv. Res. 2005;7(2):89–101. https://www.ncbi.nlm.nih.gov/pubmed/15974155 Retrieved from. -PubMed
    1. Jakupcak M., Cook J., Imel Z., Fontana A., Rosenheck R., McFall M. Posttraumatic stress disorder as a risk factor for suicidal ideation in Iraq and Afghanistan war veterans. J. Trauma. Stress. 2009;22(4):303–306. -PubMed
    1. Jordan B.K., Marmar C.R., Fairbank J.A., Schlenger W.E., Kulka R.A., Hough R.L., Weiss D.S. Problems in families of male Vietnam veterans with posttraumatic stress disorder. J. Consult. Clin. Psychol. 1992;60(6):916–926. -PubMed

LinkOut - more resources