Cognitive Processing Therapy for PTSD in Incarcerated Individuals

Overseen By Michael R Koenigs, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Wisconsin, Madison

Disqualifiers: Psychosis, Suicidal ideation, Self-harm, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 17

Duration: 6-12 weeks

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how Cognitive Processing Therapy (CPT), a type of talk therapy, can assist incarcerated individuals with PTSD, a mental health condition triggered by past trauma. Participants will either begin CPT immediately or join a waitlist as part of the control group before receiving therapy. The trial targets those in prison who have PTSD and can participate in group therapy sessions. The researchers aim to enhance mental health support for people in correctional facilities. As an unphased trial, it offers a unique opportunity to contribute to the improvement of mental health care in these settings.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that Cognitive Processing Therapy is safe for incarcerated individuals with PTSD?

Research has shown that Cognitive Processing Therapy (CPT) is generally safe for treating PTSD. In one study, only 6.9% of participants stopped the treatment, indicating a low dropout rate. This suggests that most people find the therapy manageable.

Other studies have demonstrated positive results with CPT, particularly for groups like military veterans and individuals with severe mental illness. These studies found that CPT improved PTSD and related symptoms over time. Reports of serious side effects are absent, indicating that people usually handle CPT well.

Overall, CPT has been widely studied and appears safe for most people dealing with PTSD. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments because they offer a tailored approach to managing PTSD in incarcerated individuals. Unlike standard options like medication or general talk therapy, Cognitive Processing Therapy (CPT) specifically targets the way individuals process trauma-related thoughts, helping them reframe their experiences. Additionally, incorporating a therapist-facilitated support group provides a structured space for participants to share and process their experiences, which is particularly beneficial in a prison setting where such support is often limited. This dual approach not only aims to directly address the unique psychological challenges faced by incarcerated individuals but also offers the potential for long-lasting change by equipping them with practical skills to manage PTSD symptoms.

What evidence suggests that Cognitive Processing Therapy is effective for PTSD in incarcerated individuals?

Research has shown that Cognitive Processing Therapy (CPT) effectively treats PTSD. One study demonstrated a significant reduction in PTSD symptoms, with participants' scores improving by an average of 14 points. These improvements persisted, offering long-term benefits. In this trial, participants in the CPT group will receive this therapy to treat PTSD. CPT has also proven effective in various settings, helping many individuals feel significantly better. This evidence suggests that CPT can be a promising treatment for PTSD, even in challenging environments like prisons. ^{1 2 3 6 7}

Who Is on the Research Team?

Michael Koenigs, PhD

Principal Investigator

University of Wisconsin, Madison

Are You a Good Fit for This Trial?

This trial is for incarcerated men and women aged 18 or older with PTSD, who can read at a 4th-grade level or higher, have stable medication use for at least one month, and an IQ of 70 or above. They must be willing to join group therapy but not currently in trauma-focused treatment involving processing of trauma.

Inclusion Criteria

Meet PCL-5 criteria for current PTSD diagnosis within 2 months of enrollment

Able to understand the consent form as measured by the consent quiz

No serious self-harm within the past 6 months

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

1 visit (in-person)

Pre-treatment

Pre-treatment testing session to assess baseline PTSD symptomology and other psychological measures

2 weeks

1 visit (in-person)

Treatment

Participants receive Cognitive Processing Therapy (CPT) in 12 sessions over 6 to 12 weeks

6-12 weeks

12 visits (in-person)

Post-treatment

Post-treatment testing to assess changes in PTSD symptoms and other psychological measures

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including follow-up testing and interviews

3 months

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Cognitive Processing Therapy
• Therapist-facilitated Support group

Trial Overview The study tests how effective Cognitive Processing Therapy (CPT) is compared to Therapist-facilitated Support groups in treating PTSD among the prison population. It involves four groups each for CPT and support sessions over a period of up to 22 weeks.

How Is the Trial Designed?

Group I: Cognitive Processing Therapy (CPT) group Experimental Treatment 1 Intervention

Participant groups to receive CPT to treat PTSD

Group II: Waitlist Control Active Control 1 Intervention

Participant groups will provide data as a control group first, and will then receive CPT to treat PTSD

Cognitive Processing Therapy is already approved in United States, European Union for the following indications:

Approved in United States as Cognitive Processing Therapy for:

• Posttraumatic Stress Disorder (PTSD)

Approved in European Union as Cognitive Processing Therapy for:

• Posttraumatic Stress Disorder (PTSD)

Who Is Running the Clinical Trial?

University of Wisconsin, Madison

Lead Sponsor

Trials

1,249

Recruited

3,255,000+

Wisconsin Partnership Program

Collaborator

Trials

9

Recruited

590+

Published Research Related to This Trial

Cognitive Processing Therapy (CPT) significantly improved PTSD and depression symptoms in 19 sexual assault survivors after 12 weekly group sessions, with benefits maintained for 6 months post-treatment.

In contrast, a comparison group of 20 individuals who waited for therapy showed no improvement, highlighting the efficacy of CPT in treating PTSD symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive processing therapy for sexual assault victims. Resick, PA., Schnicke, MK.[2022]

Cognitive processing therapy (CPT) effectively reduced PTSD symptoms in a 74-year-old woman veteran, indicating its potential utility for older adults with PTSD.

The case study suggests that CPT can be applied to older adults without significant modifications, highlighting its adaptability as a first-line treatment for PTSD in this demographic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Delivered as Described: A Successful Case of Cognitive Processing Therapy With an Older Woman Veteran With PTSD. Reuman, L., Davison, EH.[2023]

Cognitive processing therapy (CPT) is an effective treatment for PTSD in veterans, but many do not complete the full program, often receiving only four sessions instead of the full 12, highlighting the need for a more efficient treatment format.

A study involving 270 veterans used a fractional factorial design to identify the most effective components of CPT, aiming to create a shorter version that could reduce dropout rates and improve treatment accessibility for PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using the multiphase optimization strategy to adapt cognitive processing therapy (CPT MOST): study protocol for a randomized controlled factorial experiment. Sripada, RK., Peterson, CL., Dziak, JJ., et al.[2023]

Cognitive processing therapy (CPT) has been shown to be an effective treatment for PTSD in active duty military personnel, as demonstrated in a case study of a service member who underwent 13 therapy sessions.

The case study highlights significant progress in reducing PTSD symptoms and achieving treatment goals, showcasing the practical application of CPT in an outpatient setting and addressing clinical challenges faced during therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Case Study of Cognitive Processing Therapy for a Military Medic With Posttraumatic Stress Disorder. Wiley, RE.[2020]

In a study of 268 active-duty servicemembers, individual cognitive processing therapy (CPT) was found to be more effective than group CPT in reducing PTSD severity, with significant improvements noted immediately after treatment.

Both individual and group formats of CPT led to reductions in depression and suicidal ideation, but about 50% of participants still experienced PTSD symptoms after treatment, highlighting the need for improved or new therapeutic options in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Group vs Individual Cognitive Processing Therapy in Active-Duty Military Seeking Treatment for Posttraumatic Stress Disorder: A Randomized Clinical Trial. Resick, PA., Wachen, JS., Dondanville, KA., et al.[2022]

Cognitive Processing Therapy (CPT) effectively reduced PTSD symptoms in a study of 18 patients, with 15 participants showing statistically significant improvements in their symptom scores.

The study highlights the successful adaptation of the CPT protocol to address specific barriers faced by trauma survivors, demonstrating its potential for broader implementation in similar treatment settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive processing therapy for posttraumatic stress disorder in a residential treatment setting. Zappert, LN., Westrup, D.[2019]

Cognitive Processing Therapy (CPT) is an effective evidence-based treatment for PTSD, particularly for individuals who have experienced combat, assault, or interpersonal violence, as supported by randomized controlled trials.

The Department of Veterans Affairs has successfully implemented CPT across its healthcare system, with trained clinicians showing good adoption of the therapy and significant improvements in patients' PTSD and depressive symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dissemination and experience with cognitive processing therapy. Chard, KM., Ricksecker, EG., Healy, ET., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39908018/

Cognitive Processing Therapy for Posttraumatic Stress ... The CPT-TAU group showed a mean (SE) reduction in CAPS-5 scores of 14.00 (1.92) points, with a low dropout rate (2 of 29 [6.9%]). Patients in ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S2589979124000027

Effectiveness of Cognitive Processing Therapy for PTSD in ... This study provides promising data on the outcomes associated with a modified CPT protocol for treating PTSD in a high need but under-treated SMI population.

3. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2829857

Cognitive Processing Therapy for Posttraumatic Stress ... The CPT-TAU group maintained improvements in all outcomes from 17 to 34 weeks. Sensitivity analyses controlling for the types of traumatic ...

4. ptsd.va.gov ptsd.va.gov/professional/treat/txessentials/cpt_for_ptsd_pro.asp

Cognitive Processing Therapy for PTSD Participants in the active treatment conditions (both CPT and PE) demonstrated significant improvement in PTSD and depression over the course of treatment as ...

5. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/30332919/

A meta-analytic review of cognitive processing therapy for ... These meta-analytic findings indicate that CPT is an effective PTSD treatment with lasting benefits across a range of outcomes.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3336190/

Long-Term Outcomes of Cognitive–Behavioral Treatments ... CPT and PE resulted in lasting changes in PTSD and related symptoms over an extended period of time for female rape victims with extensive histories of trauma.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT04230668

NCT04230668 | Cognitive Processing Therapy (CPT) for ... A pilot effectiveness trial of cognitive processing therapy augmented with suicide risk management for individuals with comorbid PTSD and BPD conditions.