Trauma-focused Psychodynamic Psychotherapy for LGBT Patients With Post-traumatic Stress Disorder
Condition: Complex Post-Traumatic Stress Disorder; Post-traumatic Stress Disorder
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      This is a pilot, open trial of trauma-focused psychodynamic psychotherapy for
      LGBT-identifying individuals who meet for DSM-5 defined post-traumatic stress disorder and
      are interested in receiving a research psychotherapy intervention. A sample of at least 15
      therapy completers will be collected.
    

Detailed description: 
      Despite high prevalence of PTSD among LGBT individuals, there are no data characterizing the
      disorder in this population, nor its treatment. This represents an important under-researched
      area in LGBT care and treatment. The purpose of this study is: (a) to preliminarily
      characterize PTSD within an LGBT sample; and (b) to test out the preliminary effects and
      acceptability of a novel PTSD psychotherapy, trauma-focused psychodynamic psychotherapy, in
      this group. Participants identifying as LGBT and meeting DSM-5 criteria for PTSD per a
      structured, reliable clinical interview for PTSD will receive 20-24 sessions of twice-weekly
      TFPP at no cost. Participants will receive four detailed clinical research assessments, at
      baseline/study entry, Week 5 of treatment, treatment termination/end (Week 12), and 3-months
      after the end of treatment.

      TFPP is adapted from the only empirically supported, non-exposure focused psychodynamic
      therapy for panic disorder and anxiety disorders, panic-focused psychodynamic psychotherapy.
      TFPP aims to improve patients' ability to understand and manage strong, intense emotions that
      appear seemingly "out of the blue," which links to their tendency to reexperience traumatic
      events in the here-and-now. TFPP addresses the psychological meanings of symptoms and their
      relationship to traumatic events to help the patient understand underlying emotions
      triggering their symptoms and the ways in which trauma influences their current experiences.
      TFPP was developed for patients with complex PTSD, who often have multiple prior trauma
      exposures with no clear "index" trauma. Moreover, TFPP also explicitly considers
      opportunities for patients to explore the broader context of their symptoms and difficulties,
      including but not limited to LGBT identity or experiences of oppression.
    

Intervention name(s): Trauma-focused psychodynamic psychotherapy
Intervention type(s): Behavioral
Intervention description(s): This psychotherapy addresses disruptions in narrative coherence and affective dysregulation by exploring the psychological meanings of symptoms and their relation to traumatic events. The therapist works to identify intrapsychic conflicts, intense negative affects, and defense mechanisms related to the PTSD syndrome using a psychodynamic formulation that provides a framework for intervention. The transference provides a forum for patients to address feelings of mistrust, difficulties with authority, fears of abuse, angry and guilty feelings, and fantasies.
This treatment will be provided in-person or over teletherapy as the public health situation demands.
Other intervention name(s): TFPP
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: PTSD; psychotherapy; psychodynamic; LGBTQ