We are developing Brief Integrative Therapy (BIT) for post-traumatic stress disorder related to childhood sexual abuse (PTSD-CSA). The following problems are associated with PTSD-CSA and have guided the development of BIT: affect regulation difficulties, interpersonal problems, and feelings of powerlessness and low self-esteem that interfere with effective problem solving. Therefore, BIT integrates interpersonal, problem solving, affect regulation, and psycho-educational components. Results from our ongoing randomized clinical trial support the use of problem-solving therapy for PTSD-CSA. We believe that the addition of the above components to problem-solving therapy will result in a more effective treatment for PTSD-CSA. To date BIT is still in development and has not been tested. We propose to refine BIT and to complete our treatment manual based both on our experience with problem-solving therapy and on clinical experience with 4-6 pilot participants. We then propose to teach master's level therapists to deliver BIT with high levels of integrity and competency. To this end, we propose to develop and to apply a treatment integrity checklist and competency. To this end, we propose to develop and to apply a treatment integrity checklist and to select and to apply a therapist competency measure. Following extensive training, and guided by our BIT manual and ongoing supervision, three master's level therapists will each treat five volunteer participants. Therapy session videotapes from each therapist will be rated using the integrity and competency measures. We also propose to assess the immediate and short-term effectiveness of BIT in a one-group, pre-post-follow-up design, studying the 15 volunteer participants treated by the master's level therapists. We hypothesize that BIT will: 1) reduce PTSD symptoms assessed with the Clinician Administered PTSD Scale; 2) improve quality of life, social adjustment, beliefs about safety, and self-efficacy; and 3) reduce self-reported depressive and anxiety symptoms. The immediate post-treatment effects of BIT will be examined with paired t-tests, and the three-month follow- up data will be analyzed by repeated measures MANOVA.
