Effectiveness of Cognitive Behavioral Couples Therapy for Post-traumatic Stress Disorder
Condition: Post-traumatic Stress Disorder
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      This study will evaluate the effectiveness of cognitive behavioral couples therapy designed
      for post-traumatic stress disorder in reducing symptoms of post-traumatic stress disorder and
      in improving relationship functioning.
    

Detailed description: 
      Post-traumatic stress disorder (PTSD) is a highly prevalent and disabling disorder that
      affects about 7.7 million adults in the United States. PTSD can develop after someone
      experiences a particularly distressing event that may involve the threat of or actual
      physical harm. Common symptoms of PTSD include avoidance of situations or cues that may act
      as reminders of the event, reoccurring flashbacks of the event, loss of interest in
      previously enjoyed activities, and numbing of emotions. Additionally, PTSD is often
      associated with far-reaching and devastating interpersonal relationship problems that can
      maintain or aggravate other PTSD symptoms. These interpersonal problems can also interfere
      with successful treatment delivery, so addressing such problems is important for improving
      treatment compliance, effectiveness, and long-term success. Cognitive behavioral therapy
      (CBT) is a type of psychotherapy that teaches ways to modify thoughts and behaviors that
      contribute to PTSD. CBT that is adapted for couples in which one partner has PTSD may be the
      most effective means of decreasing individual PTSD symptoms and improving the couple's
      relationship. This study will evaluate the effectiveness of cognitive behavioral couples
      therapy (CBCT) for PTSD in reducing symptoms of PSTD and in improving relationship
      functioning for couples in which one partner has PTSD.

      Participation in this study will last 8 months. All participants will undergo baseline
      assessments that will include an interview about exposure to traumatic events, PTSD symptoms,
      mental health problems, and substance use; self-report questionnaires about mood, social and
      leisure activities, and relationships; and a brief video-recorded communication session as a
      couple. Eligible participants will then be assigned randomly to receive immediate CBCT for
      PTSD or delayed CBCT for PTSD. Participants in the delayed treatment group will receive
      active treatment after a 3-month waitlist period. CBCT for PTSD will include fifteen
      75-minute couples therapy sessions, occurring twice weekly for 3 weeks and weekly for the
      remaining 9 weeks of treatment. Sessions will follow manual-based couples therapy and will
      aim to both decrease individual PTSD symptoms and enhance dyadic functioning. After each
      session, participants will also complete out-of-session practice assignments that will
      include completing worksheets and practicing skills taught in therapy sessions.

      Participants receiving immediate CBCT for PTSD will undergo subsequent assessments at
      mid-treatment, end of treatment, and 3 months after the end of treatment. Participants
      receiving delayed treatment will undergo assessments 1 and 3 months into the wait-list period
      and at the end of treatment. Assessments will include questions about PTSD and mental health
      symptoms, alcohol and substance use, intimate relationship functioning, and family and social
      activities. Participants will repeat the communication session after the end of treatment for
      the group receiving immediate therapy and at the end of the wait-list period for the delayed
      treatment group.
    

Intervention name(s): Cognitive behavioral couples therapy for post-traumatic stress disorder (CBCT for PTSD)
Intervention type(s): Behavioral
Intervention description(s): CBCT for PTSD is a 15-session manualized couples therapy that aims to both decrease individual PTSD symptoms and improve dyadic functioning.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: PTSD; Relationship Distress; Couple Therapy