Cognitive Processing Therapy for Posttraumatic Stress Disorder and Co-occurring Lived Experience Stress

N/ANot Yet RecruitingNCT07714083

Boston University52 enrolled

Overview

Populations facing health disparities include groups with significantly higher rates of posttraumatic stress disorder than the general population who frequently experience lived experience stress, which may complicate posttraumatic stress disorder symptom presentations. However, there are currently no posttraumatic stress disorder treatments designed to meet the unique needs of these individuals. The proposed study will pilot an adaptation of Cognitive Processing Therapy (a gold-standard treatment for posttraumatic stress disorder) that has been modified to incorporate the impact of lived experience stress as an additional treatment target. This project has the potential to advance our understanding of how to enhance Cognitive Processing Therapy in order to optimize posttraumatic stress disorder treatment response and mitigate health disparities.

This study will occur in two phases. Phase 1 will involve refining Cognitive Processing Therapy Lived Experience Adapted Protocol (CPT-LEAP) and includes beta testing of CPT-LEAP (n=6). Phase 2 will involve a pilot RCT in which participants (n=52) will be randomized (1:1) to standard CPT or CPT-LEAP. The investigators anticipate 26 participants will be enrolled in each treatment arm.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Post Traumatic Stress Disorder

Interventions

Standard CPTBEHAVIORAL

CPT focuses on teaching skills to identify and challenge PTSD-maintaining maladaptive beliefs related to the trauma itself, the world, and oneself. Worksheets and assignments are given between each session.

CPT-LEAPBEHAVIORAL

CPT-LEAP frames each session in relation to beliefs about both traumatic and lived experience stressors and their interactions and impacts, including not only beliefs about oneself, others, and the world, but also one's identity, and use of relevant examples throughout the protocol.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Current diagnosis of PTSD * Self-identification as a sexual or gender minority (SGM) individual * Endorsement of SGM stress experiences with moderate distress * For patients who take psychiatric medication, stable dose one month prior to enrollment * Reside in Massachusetts. Exclusion Criteria: * Current active suicidal or homicidal ideation with intent or plan * Unstable bipolar disorder/current mania * Unstable psychotic disorder/current psychosis * Current severe substance use that warrants immediate medical attention * Cognitive impairment or organic disorder (e.g., advanced dementia, severe traumatic brain injury) that impairs ability to complete CPT procedures * Past completion of CPT or current trauma-focused treatment * Unwillingness to consent to audio or video recording of assessment and treatment sessions

Outcomes

Primary Outcomes

Post traumatic stress disorder symptoms (PTSD)

Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (CAPS-5). The CAPS-5 includes 20 items assessing PTSD symptom severity. Total scores range from 0-80 with higher scores indicating more severe PTSD symptoms.

Time frame: immediately after treatment, 3 months