Effectiveness in routine care: trauma-focused treatment for PTSD

Area of Science:

• Psychiatry
• Clinical Psychology
• Evidence-Based Practice

Background:

• Trauma-focused cognitive behaviour therapy (tf-CBT) has demonstrated efficacy in randomized controlled trials (RCTs).
• Further research is needed to confirm tf-CBT's effectiveness in real-world clinical practice.
• Post-traumatic stress disorder (PTSD) requires effective and accessible treatment options.

Purpose of the Study:

• To evaluate the effectiveness of tf-CBT delivered in routine outpatient clinical care settings.
• To assess the tolerability and applicability of tf-CBT for patients with PTSD.
• To investigate potential moderators of treatment outcome in a clinical population.

Main Methods:

• Eighty-five patients diagnosed with PTSD received tf-CBT at two German outpatient centers.
• Treatment involved preparation, trauma-focused, and recovery phases, delivered by therapists in training.
• Intent-to-treat analyses used linear mixed effects models with PTSD Checklist for DSM-5 (PCL-5) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) data.

Main Results:

• Large treatment effects were observed for both CAPS-5 (Cohen's d = 2.07) and PCL-5 (Cohen's d = 2.02) in intent-to-treat analyses.
• These significant treatment effects remained stable at six months and one year post-treatment.
• The study reported a dropout rate of 31.48%, with 14.12% completing treatment despite dropping from the study.

Conclusions:

• Trauma-focused cognitive behaviour therapy (tf-CBT) is well-tolerated and effective in routine clinical care.
• The substantial treatment effects highlight the practicality and benefits of tf-CBT.
• The findings support the broad applicability of tf-CBT for individuals with varied clinical characteristics and comorbidities.