A randomized controlled effectiveness trial of training strategies in cognitive processing therapy for posttraumatic stress disorder: Impact on patient outcomes.

Monson CM, Shields N, Suvak MK, Lane JEM, Shnaider P, Landy MSH, Wagner AC, Sijercic I, Masina T, Wanklyn SG, Stirman SW. A randomized controlled effectiveness trial of training strategies in cognitive processing therapy for posttraumatic stress disorder: Impact on patient outcomes. Behaviour Research and Therapy. 2018 Nov 1; 110:31-40.

Related HSR&D Project(s)

• SDR 10-012 – Women's Health Research Consortium/Practice-Based Research Network

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

This randomized controlled hybrid implementation/effectiveness trial aimed to compare the impact of three different models of training and consultation by examining the PTSD treatment outcomes achieved by therapists who were learning a front-line recommended psychotherapy for posttraumatic stress disorder (PTSD), Cognitive Processing Therapy (CPT; Resick, Monson, and Chard, 2017). Therapists (N? = 134) were randomized into one of three conditions after attending a standard CPT training workshop: No Consultation with delayed feedback on CPT fidelity, Standard Consultation involving discussion and conceptualization of cases without session audio review, and Consultation Including Audio Review, which included a review of segments of audiorecorded CPT sessions. Across all training conditions, the patients treated by these therapists (N? = 188) evidenced statistically significant reductions in PTSD symptoms, (d? = -0.95 to -1.78), comorbid symptoms and functioning (d? = -0.27 to -0.51). However, patients of therapists in the Standard Consultation condition (?PTSD? = - 19.64, d? = -1.78) experienced significantly greater improvement than those in the No Consultation condition (?PTSD? = - 10.54, d? = -0.95, ?DEV? = 6.30, ?Parms? = 2, p? = .043). This study demonstrates that patients who receive evidence-based psychotherapy for PTSD in routine care settings can experience significant symptom improvement. Our findings also suggest that to maximize patient benefit, therapist training should include consultation, but that audio review of sessions during consultation may not be necessary, at least for structured protocols. Implications for implementation, including the reduction of burden and cost of post-workshop support, are discussed.