Comparison of Cognitive Processing Therapy (CPT) and Dialogical Exposure Therapy (DET) for Posttraumatic Stress Disorder

Study Overview
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Brief Summary
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This study aims to compare two active psychological treatments for PTSD. One is an established therapy, Cognitive Processing Therapy (CPT) which operates as a control condition for a newly developed intervention, an integrative Gestalt-based trauma therapy, Dialogical Exposure Therapy (DET). There is no inactive control condition. We expect the two therapies to perform on a similar level, which would constitute evidence for the efficacy of DET.

Official Title
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Comparison of a Gestalt-based Approach to PTSD Therapy With Cognitive Processing Therapy

Conditions
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Posttraumatic Stress Disorder

Intervention / Treatment
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* Behavioral: Dialogical exposure therapy
* Behavioral: Cognitive Processing Therapy (German Adaptation)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: main diagnosis of posttraumatic stress disorder time since trauma is at least three months Exclusion Criteria: acute suicidal ideation severe personality pathology substance dependence early childhood trauma (e.g. child sexual abuse) history of psychosis dissociative identity disorder neurological impairment (e.g. craniocerebral injury with functional impairment) severe pre-traumatic depression ongoing psychotherapy lack of motivation lack of German language skills

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dialogical exposure therapy<br>Psychotherapy based on a manual integrating Gestalt principles with cognitive-behavioral techniques. | Behavioral: Dialogical exposure therapy<br>* This 24-session treatment protocol includes cognitive-behavioral components integrated with a frame based on gestalt principles. There are four phases, safety, stabilization, confrontation and integration.<br>|
| Active Comparator: Cognitive Processing Therapy<br>Cognitive Processing Therapy, a cognitive behavioral psychotherapy for PTSD patients. Based on a German manual adapted from Resick and Schnicke, 1993. | Behavioral: Cognitive Processing Therapy (German Adaptation)<br>* This is a German adaptation of Cognitive Processing Therapy, developed by Prof. P. A. Resick. This intervention includes cognitive restructuring, a focus on the traumatic memory and a focus on issues that are likely to be problematic in traumatized individuals.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PTBS Symptom Severity | Even though participants are assessed by a clinical interview before entering the study, the primary outcome measure is the PDS which is applied before and after treatment as well as at 6-month follow-up. | change from pretreatment to posttreatment (planned duration 12 weeks on average) to follow-up (six months after posttreatment) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PTSD Symptom change (IES-R) | The IES-R is a short instrument for the measurement of PTSD symptom severity. In this study, the IES-R is applied before every session in order to measure symptom change over the time of the therapy. | change from pretreatment to posttreatment (planned duration 12 weeks on average) to follow-up (six months after posttreatment). Also measured at each session (up to 24 time points between pre- and posttreatment). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Posttraumatic Stress Disorder, psychotherapy, randomized trial, gestalt, PTSD