Post-traumatic stress disorder (PTSD) is a common and often disabling condition that can develop following exposure to military (e.g., combat) and non-military (e.g., violent crimes, severe accidents) traumatic events. Prior research has led to the development of treatments that are effective in reducing the symptoms of PTSD in many people, one of which is a treatment called Prolonged Exposure (PE). This treatment has been found effective in several studies in which individuals with PTSD receive between 9 and 12 therapy sessions administered once or twice weekly. Thus, treatment has typically taken place over the course of 5-12 weeks. This study is designed to evaluate whether this treatment can be made more efficient, by conducting daily sessions and thereby permitting a full 10-sesion course of treatment to be administered within 2 weeks, without sacrificing effectiveness. This is an important service-delivery question because rapid treatment will reduce the duration of suffering and impairment caused by the PTSD. In addition, and particularly relevant to the military context, rapid treatment will permit active duty personnel to more quickly return to their responsibilities and permit those leaving active service to minimize the negative impact that service-related PTSD may have on their transition to civilian life.
To accomplish the above goals, this study will compare standard PE treatment (10 sessions completed within 8 weeks) with the same number of PE sessions administered in 2 weeks. A third comparison group, which involves a 2-week period of no treatment (called waitlist) prior to receiving the full treatment, will also be included in this study. Potential participants for this study are adult men and women with PTSD resulting from service in Operations Enduring Freedom or Iraqi Freedom (OEF/OIF), either active duty personnel or recent veterans. Individuals meeting the full study criteria, which is determined in a free comprehensive evaluation, will be randomly assigned to one of three conditions: Standard PE (10 90-minute sessions administered in 8 weeks), rapid PE (10 90-minute sessions administered in 2 weeks), or brief waitlist (a 2-week period of no treatment). Participants assigned to the waitlist condition will then be provided with a full course of PE (10 90-minute sessions), which can be delivered in either 8 weeks or 2 weeks, depending on the participant's preference. At several points during the treatment and after the treatment, participants will be assessed to evaluate the effectiveness of treatment and how well treatment gains are maintained upon completion of treatment (up to 12 weeks post-treatment). The assessments will include measures of PTSD severity, anxiety, depression, anger, and trauma-related thoughts to obtain a thorough understanding of the effects of PTSD treatment across a range of related domains. Altogether, this study will attempt to recruit 210 participants, 90 of whom will receive standard PE, 90 of whom will receive rapid PE, and 30 of whom will first enter the waitlist period followed by standard or rapid PE according to their preference.
The results of this study will inform us whether or not military-related PTSD can be treated in a short period of time (i.e., 2 weeks) and whether or not rapid treatment significantly reduces the effectiveness of standard treatment. If the results show that PTSD can be treated rapidly and without loss of effectiveness, then implementation of such rapid treatment programs can significantly reduce the duration of dysfunction caused by PTSD and more rapidly help military personnel affected by PTSD acquired during their service to America either return to their military responsibilities or minimize the negative consequences of military-related PTSD as they enter civilian life.