Implementation of Prolonged Exposure in the Military
Condition: PTSD
Study type: Interventional

Summary: 
      This randomized study examines how prolonged exposure (PE) therapy, an evidence-based
      treatment for posttraumatic stress disorder (PTSD), can be successfully disseminated and
      implemented in the Army. The study compares two PE training models: Standard PE training,
      comprised of a 4-day workshop only, and Extended PE training, comprised of a 4-day workshop
      plus expert case consultation. In addition, patients with posttraumatic stress symptoms
      receiving psychotherapy from participating providers will be invited to participate. After
      completing PE training, use of PE components with patients reporting PTS symptoms and
      clinical outcomes of these participating patients will be monitored for up to 18 months.
    

Detailed description: 
      This study will examine how evidence-based therapies (EBTs) such as Prolonged Exposure (PE)
      for posttraumatic stress disorder (PTSD) can be successfully disseminated and implemented in
      the Army by comparing two PE training models: Standard PE training (workshop only) and
      Extended PE training (workshop plus consultation). Up to 180 mental health providers at three
      medium-to large Army installations will be randomly assigned to either Standard PE training
      or Extended PE training. All providers will complete a 4-day PE workshop, along with the
      distribution of training materials and treatment manuals, conducted at the military site by
      the Overall Study PI, Dr. Edna Foa, and her team. Following the 4-day workshop, participants
      randomized to the Extended PE training will receive weekly phone consultation with a PE
      expert on two PE therapy cases. Participants randomized to the Standard PE training group
      will not receive any additional consultation following the workshop. Providers will not be
      required to use PE therapy with their patients with PTS symptoms; using PE will be optional.
      A major outcome of this study is the proportion of the providers PTSD patients that are
      offered PE or PE components. The mental health outcomes of providers' PTS patients will also
      be monitored as a second major outcome. Patients seeking treatment from participating
      providers will be recruited, consented, and assessed by independent evaluators at two time
      points to prospectively assess their response to treatment.
    

Intervention name(s): Extended Training in Prolonged Exposure Therapy for PTSD; Standard Training in Prolonged Exposure Therapy for PTSD
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Extended training in Prolonged Exposure consists of a 4-day PE workshop, followed by expert PE consultation on 2 training cases. PE consultation consists of weekly telephone calls with expert PE therapists at the University of Pennsylvania, who will review video-recordings of providers PE sessions and provide feedback. Consultation is considered complete if the consultant has reviewed a minimum of 12 video-recorded sessions across 2 training cases, and has provided feedback on all of the crucial elements of PE (e.g., rationale, imaginal exposure, in vivo exposure, processing).; Standard training in PE consists of a 4-day professional workshop on Prolonged Exposure Therapy. This is similar to the standard training approach that has been used to train providers in delivery of PE in the Army.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: posttraumatic stress symptoms; implementation; dissemination; PTSD