Reducing Posttraumatic Stress Disorder (PTSD) Symptoms in First Responders and Frontline Health Care Workers

University of Michigan410 enrolled

Overview

This study addresses PTSD symptoms in First Responders and Healthcare workers. Specifically, it tests whether a brief PTSD treatment (talk therapy) effectively treats PTSD when provided to First Responders and Healthcare workers by counselors in Employee Assistance Programs (EAPs). The central hypothesis is that the PTSD treatment, Prolonged Exposure for Primary Care (PE-PC), will reduce PTSD symptoms and improve functioning, compared to EAP Treatment as Usual (TAU).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

410

Conditions

Post Traumatic Stress Disorder

Interventions

Prolonged Exposure for Primary Care (PE-PC)

Treatment will be given by telehealth or in person, depending on the participant preference. Content is drawn from the Full Prolonged Exposure model and condensed so as to deliver the most efficacious components in a brief format. There will be 4-6 weekly 30-minute sessions. Treatment follows the standardized PE-PC manual and workbook. At the end of the final session, the counselor and participant will review treatment progress and either conclude treatment or refer the participant to outside mental healthcare for more intensive treatment. Participants will complete surveys and complete homework during and following the study.

EAP Treatment as Usual (TAU)BEHAVIORAL

Treatment will be given by telehealth or in person, depending on the participant preference and current EAP practices (4-6 weeks). This will be the standard of care practice at each EAP site. Usually, this includes up to six sessions of solution focused therapy, and referrals to an established network of community providers who specialize in PTSD treatment. All PTSD care received during the study will be collected and monitored as TAU. The type of TAU used will reflect the current practice in EAPs and will not be constrained in the study design. EAP staff will monitor and record all EAP care received, including tracking no shows and cancellations. Study team members will document care received outside of the EAP (including psychiatric medications) by self-report. Participants will complete surveys and complete homework during and following the study.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Are employees at an orginization served by a participating EAP * Have a Post-Traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) score ≥33 * Have had psychotropic medication stability for at least 4 weeks Inclusion criteria for the qualitative portion of the study: \- Enrolled into the randomized clinical trial and were a treatment responder or were a treatment non-responder Exclusion Criteria: * Severe cognitive impairment that in the judgment of the investigators makes it unlikely that the participant can adhere to the study regimen (as evidenced by confusion, inability to track discussion or answer questions, or other clear and significant indicators of cognitive impairment) * High risk of suicide (defined as meeting criteria for Action Step 3 on the Participant Suicide Risk Screening form: found in protocol) * Need for detoxification * Active psychosis or unmanaged bipolar disorder, as measured by items 12 and 13 of the cross cutting assessment * Currently engagement in a trauma-focused behavioral treatment (such as Prolonged Exposure or Cognitive Processing Therapy). * Patients who do not speak English will be excluded for logistical reasons.

Locations (12)

Sharp Healthcare

San Diego, California, United States

WITHDRAWN

Tanner Health System

Carrollton, Georgia, United States

RECRUITING

University of Michigan

Ann Arbor, Michigan, United States

RECRUITING

Henry Ford Health System

Detroit, Michigan, United States

ACTIVE_NOT_RECRUITING

Detroit Fire Department

Detroit, Michigan, United States

RECRUITING

Health Management Systems of America

Detroit, Michigan, United States

RECRUITING

Michigan State University

East Lansing, Michigan, United States

RECRUITING

West Bloomfield Fire Department

West Bloomfield, Michigan, United States

ACTIVE_NOT_RECRUITING

Cope NewYork-Presbyterian

New York, New York, United States

RECRUITING

University of Cincinati Health

Cincinnati, Ohio, United States

NOT_YET_RECRUITING

...and 2 more locations

Outcomes

Primary Outcomes

Change in Post-Traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) score

The PCL-5 is a 20-item self-report measure that assesses symptoms of PTSD. The self-report rating scale is 0-4 for each symptom. The minimum and maximum values are 0 and 80, with higher scores indicating worse outcome.