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Ralph G. DePalma Memorial TBI Clinical Strategies

Massed vs Intensive Outpatient Prolonged Exposure for Combat-Related Posttraumatic Stress Disorder


by Alan Peterson, PhD, ABPP
Seminar date: 5/10/2023

Description: Combat-related PTSD in service members and Veterans has been found to be more difficult to treat than in many civilian populations. There are a number of hypothesized reasons for this including the type and frequency of traumatic exposures and the unique aspects of exposure to repeated explosive blasts. This suggests that improved, efficient, and efficacious treatments are needed that are tailored for the unique needs of military personnel and Veterans. The current study evaluated the efficacy of Massed-Prolonged Exposure (Massed-PE; 15 sessions, 90 minutes each, over 3 weeks) and Intensive Outpatient Program Prolonged Exposure (IOP-PE; 15 full-day sessions over 3 weeks with 8 treatment augmentations). The results indicated that Clinician-Administered PTSD Scale (CAPS-5) scores decreased significantly in both treatment arms at the 1-month follow-up. PTSD symptoms increased in Massed-PE participants during follow-up, whereas IOP-PE participants-maintained treatment gains. Self-reported PTSD symptoms on the PCL-5 decreased in both arms from baseline to 1-month follow-up. Approximately 50% of patients in each group Both achieved PTSD diagnostic remission through the 6-month follow-up. Most participants demonstrated reliable change on the CAPS-5 (60.7%) and the PCL-5 (74.3%) at 1-month follow-up. These findings suggest that PE can be adapted into compressed treatment formats that effectively reduce PTSD symptoms.

Objectives: The objectives of this presentation are to review the unique aspects of blast-related combat PTSD and the results of a randomized clinical trial evaluating two versions of a 3-week intensive outpatient treatment program.

Intended Audiences: This presentation is intended for clinicians and researchers who study and treat active duty military personnel and veterans with PTSD and TBI.

View archived session video:



DOWNLOAD: PDF handout | Audio only (mp3) | transcript not yet available


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