A randomized clinical trial of group cognitive processing therapy compared with group present-centered therapy for PTSD among active duty military personnel.
OBJECTIVE
To determine whether group therapy improves symptoms of posttraumatic stress disorder (PTSD), this randomized clinical trial compared efficacy of group cognitive processing therapy (cognitive only version; CPT-C) with group present-centered therapy (PCT) for active duty military personnel.


METHODS
Patients attended 90-min groups twice weekly for 6 weeks at Fort Hood, Texas. Independent assessments were administered at baseline, weekly before sessions, and 2 weeks, 6 months, and 12 months posttreatment. A total of 108 service members (100 men, 8 women) were randomized. Inclusion criteria included PTSD following military deployment and medication stability. Exclusion criteria included suicidal/homicidal intent or other severe mental disorders requiring immediate treatment. Follow-up assessments were administered regardless of treatment completion. Primary outcome measures were the PTSD Checklist (Stressor Specific Version; PCL-S) and Beck Depression Inventory-II. The Posttraumatic Stress Symptom Interview (PSS-1) was a secondary measure.


RESULTS
Both treatments resulted in large reductions in PTSD severity, but improvement was greater in CPT-C. CPT-C also reduced depression, with gains remaining during follow-up. In PCT, depression only improved between baseline and before Session 1. There were few adverse events associated with either treatment.


CONCLUSIONS
Both CPT-C and PCT were tolerated well and reduced PTSD symptoms in group format, but only CPT-C improved depression. This study has public policy implications because of the number of active military needing PTSD treatment, and demonstrates that group format of treatment of PTSD results in significant improvement and is well tolerated. Group therapy may an important format in settings in which therapists are limited.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
Patricia A
PA
Resick
National Center for PTSD at VA Boston Healthcare System.
Jennifer Schuster
JS
Wachen
Department of Psychiatry, University of Texas Health Science Center at San Antonio.
Jim
J
Mintz
Department of Psychiatry, University of Texas Health Science Center at San Antonio.
Stacey
S
Young-McCaughan
Department of Psychiatry, University of Texas Health Science Center at San Antonio.
John D
JD
Roache
Carl R. Darnall Army Medical Center.
Adam M
AM
Borah
Department of Psychiatry, University of Texas Health Science Center at San Antonio.
Elisa V
EV
Borah
Department of Psychiatry, University of Texas Health Science Center at San Antonio.
Katherine A
KA
Dondanville
Department of Psychiatry, University of Pennsylvania School of Medicine.
Elizabeth A
EA
Hembree
Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System.
Brett T
BT
Litz
Department of Psychiatry, University of Texas Health Science Center at San Antonio.
Alan L
AL
Peterson
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D011615:Psychotherapy, Group / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*