Individual sessions of cognitive processing therapy (CPT) – a trauma-focused treatment that teaches patients more balanced thinking about traumatic events – were better at reducing the severity of posttraumatic stress disorder (PTSD) in active-duty military members, although group sessions also were effective, according to an article published online by JAMA Psychiatry.
Posttraumatic stress disorder (PTSD) is a serious problem among active-duty military personnel, especially those returning from combat deployment. More data are needed on the efficacy of individual and group therapy treatment for active-duty personnel.
Patricia A. Resick, Ph.D., of the Duke University Medical Center, Durham, N.C., and coauthors conducted a randomized clinical trial of 268 active-duty personnel seeking treatment for posttraumatic stress disorder (PTSD) at Fort Hood, Texas, after being deployed near Iraq or Afghanistan. The participants were nearly all men (91 percent) with an average age of 33.
The participants were assigned to cognitive processing therapy (CPT) in either 90-minute group sessions (n=133 participants) or 60-minute individual sessions (n=135 participants) twice weekly for six weeks. The 12 sessions (group and individual) were conducted concurrently. Assessment tools were used to measure posttraumatic stress disorder (PTSD) severity, as well as the secondary outcomes of depression and suicidal ideation.
The authors report greater improvement in posttraumatic stress disorder (PTSD) severity when participants received cognitive processing therapy in individual compared with group sessions, although improvements were maintained during the six-month follow-up in both groups, according to the results. Patients assigned to individual cognitive processing therapy had about twice as much improvement.
Depression and suicidal ideation improved equally with both forms of cognitive processing therapy. Still, about 50 percent of the participants, including those receiving individual cognitive processing therapy, still had posttraumatic stress disorder (PTSD) and significant symptoms.
Possible explanations for why patients in individual cognitive processing therapy may have fared better include that those in group received less individual attention and those who missed group cognitive processing therapy sessions missed content that could not be replaced, the authors report. Limitations to the study include patients lost to treatment because of military discontinuation.
Citation: Resick PA, Wachen JS, Dondanville KA, Pruiksma KE, Yarvis JS, Peterson AL, Mintz J, and the STRONG STAR Consortium. Effect of Group vs Individual Cognitive Processing Therapy in Active-Duty Military Seeking Treatment for Posttraumatic Stress DisorderA Randomized Clinical Trial. JAMA Psychiatry. Published online November 23, 2016. doi:10.1001/jamapsychiatry.2016.2729
Adapted from press release by JAMA