The mental health needs of veterans within the VA Healthcare system are notable. With the substantial increase over the past 10 years in veterans seeking Posttraumatic Stress Disorder (PTSD) treatment services, the VA system is straining to accommodate these needs, relying heavily on group-based treatments. The proposed research will take the next step in the literature on group psychotherapy for PTSD by examining a group cognitive behavioral treatment (GCBT) program with promising pilot data. This application supports a randomized controlled trial, which will compare GCBT with Supportive Group Psychotherapy (SGP). The trial will involve 196 male veterans with combat-related PTSD who will be randomly assigned to GCBT (n= 98) or SGP (n =98) to determine efficacy within a naturalistic care environment. Outcome data will be collected pre-treatment, mid-treatment, post-treatment, and 6- and 12- month follow-up.
Two aims are included, one focusing on outcome with respect to PTSD symptom severity, the second focusing on treatment generalization to comorbid emotional disorders (major depressive disorder, generalized anxiety disorder, and alcohol abuse), and distress and impairment. Data will be examined using latent growth curve modeling, with emphasis on determining efficacy and effectiveness. The information provided by the proposed project could assist in developing more effective care models for individuals with chronic PTSD from numerous traumatic experiences. Additionally, this project represents an effort to move the literature on group-based treatments for PTSD ahead, through inclusion of advanced methodological and analytic approaches.

Public Health Relevance

Within the VA healthcare system, group interventions for PTSD are highly prevalent and often preferred by patients with chronic PTSD. Because the need for PTSD treatment services within the VA healthcare system is enormous, some VA sites are only able to offer group treatment for PTSD in order to accommodate the large number of veterans seeking services. This has resulted in group treatment as the most frequently used PTSD treatment in the VA system. However, the high demand for PTSD group treatment is problematic given the sparse empirical literature on the efficacy and effectiveness of group treatment for PTSD. If the GCBT intervention that my collaborators and I have developed is found to be effective, it will vastly improve the available mental healthcare for this group of veterans as we would have a group treatment for PTSD with known effectiveness.

National Institute of Health (NIH)
Veterans Affairs (VA)
Non-HHS Research Projects (I01)
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Mental Health and Behavioral Science A (MHBA)
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VA Boston Health Care System
United States
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Weathers, Frank W; Bovin, Michelle J; Lee, Daniel J et al. (2018) The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychol Assess 30:383-395
Sloan, Denise M; Unger, William; Lee, Daniel J et al. (2018) A Randomized Controlled Trial of Group Cognitive Behavioral Treatment for Veterans Diagnosed With Chronic Posttraumatic Stress Disorder. J Trauma Stress 31:886-898
Sloan, Denise M; Unger, William; Gayle Beck, J (2016) Cognitive-behavioral group treatment for veterans diagnosed with PTSD: Design of a hybrid efficacy-effectiveness clinical trial. Contemp Clin Trials 47:123-30