UK Researchers from the University of Oxford, the Oxford Cognitive Health Clinical Research Facility, the National Institute for Health Research (NIHR), the Mental Health Biomedical Research Centre at South London and Maudsley, the NHS Foundation Trust and King’s CollegeLondon investigated whether cognitive therapy for PTSD can be delivered effectively in a shortened, 7-day intensive version of a method that is normally administered weekly or bi-weekly over several months.
Patients with chronic PTSD (N=121) were randomlzed to 7-day intensive cognitive therapy for PTSD; 3 months of standard weekly cognitive therapy; 3 months of weekly emotion-focused supportive therapy, or a 14-week waiting list condition.
The primary outcomes measured were change in PTSD symptoms and diagnosis as measured by independent assessor ratings and self-report.
The secondary outcomes were change in disability, anxiety, depression, and quality of life.
Evaluations were conducted at the baseline assessment and at 6 and 14 weeks (the posttreatment/wait assessment). For groups receiving treatment, evaluations were also conducted at 3 weeks and follow-up assessments at 27 and 40 weeks after randomization. All analyses were intent-to-treat.
The data showed that at the posttreatment/wait assessment, 73% of the intensive cognitive therapy group, 77% of the standard cognitive therapy group, 43% of the supportive therapy group, and 7% of the waiting list group had recovered from PTSD.
All treatments were well tolerated and were superior to the waiting list on nearly all outcome measures. No difference was observed between supportive therapy and waiting list on quality of life.
For primary outcomes, disability, and general anxiety, intensive and standard cognitive therapy were superior to supportive therapy.
Intensive cognitive therapy achieved faster symptom reduction and comparable overall outcomes to standard cognitive therapy.
The researchers conclude that cognitive therapy for PTSD, delivered intensively over little more than a week, was as effective as cognitive therapy delivered over 3 months. Both had specific effects and were superior to supportive therapy.
Intensive cognitive therapy for PTSD was shown to be a feasible and promising alternative to traditional weekly treatment.
Citation: Ehlers A, Hackmann A, Grey N, Wild J, Liness S, Albert I, Deale A, Stott R, Clark DM. A randomized controlled trial of 7-day intensive and standard weekly cognitive therapy for PTSD and emotion-focused supportive therapy. American Journal of Psychiatry. 2014 Mar 1;171 (3): pages 294-304.anke.ehlers@psy.ox.ac.uk
