Trauma Resilience and Recovery Program for PTSD

Overseen By Susan Kartiko, MD/PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

Disqualifiers: Cognitive impairment, Active psychosis, Substance abuse, others

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

Compensation: Varies

Number of Visits: 3

350 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the Trauma Resilience and Recovery Program treatment for PTSD?

The Trauma Resilience and Recovery Program (TRRP) has shown high engagement rates in trauma centers, indicating its potential effectiveness in addressing PTSD and depression after traumatic injuries. Additionally, similar programs like the PTSD Recovery Program have been effective in reducing PTSD symptoms in different populations, such as refugees, suggesting that TRRP may also be beneficial. ^{1 2 3 4 5}

How is the Trauma Resilience and Recovery Program (TRRP) treatment different from other PTSD treatments?

The Trauma Resilience and Recovery Program (TRRP) is unique because it is a technology-enhanced model that combines education, screening, and service referrals to address PTSD and depression after traumatic injury, focusing on high engagement even in resource-limited settings. Unlike traditional cognitive therapies, it uses a 'bottom-up' approach, emphasizing sensory awareness for emotion regulation, which may be more effective for trauma recovery. ^{3 4 5 6 7}

What is the purpose of this trial?

The purpose of this study to learn about patients' experience with the Trauma Resilience and Recovery program (TRRP) and/or the enhanced care group.

Research Team

Kenneth Ruggiero, PhD

Principal Investigator

Medical University of South Carolina

Eligibility Criteria

This trial is for English or Spanish speakers aged 16+ who are admitted to George Washington University's trauma center and show a risk for PTSD or depression after injury. Exclusions include severe brain injuries, cognitive impairments, psychosis, inability to communicate verbally, or serious substance abuse.

Exclusion Criteria

Patients who have a Glasgow Coma Scale score under 13 at hospital admission

Patients with moderate to severe cognitive impairment (as measured by the Montreal Cognitive Assessment)

I do not have a current, serious substance abuse problem.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Intervention

Participants receive education at the bedside about mental health recovery after traumatic injury, risk assessment, and brief intervention for high-risk patients

1-2 weeks

In-person at the trauma center

Symptom Monitoring and Education

Participants engage in symptom self-monitoring and continued education via an automated text messaging system

4 weeks

PTSD and Depression Screening

Screening for PTSD and depression by chatbot or telephone 30 days post-injury

1 week

Virtual

Referral and Handoff

Referral and warm handoff to mental health services if needed

Ongoing as needed

Follow-up

Participants are monitored for clinical and functional outcomes at 3-, 6-, and 12-months post-baseline

12 months

3 visits (in-person or virtual)

Treatment Details

Interventions

• Trauma Resilience and Recovery Program

Trial Overview The study evaluates the Trauma Resilience and Recovery Program (TRRP) compared with enhanced care in patients at risk of developing PTSD or depression following traumatic injury. It aims to understand patient experiences within these programs.

Participant Groups

Group I: Trauma Resilience and Recovery Program Experimental Treatment 1 Intervention

TRRP is a stepped model of care that delivers education at the bedside about mental health recovery after traumatic injury as well as risk assessment and brief intervention for high-risk patients (Step 1), fosters symptom monitoring and continued education (Step 2), screens for PTSD and depression 30 days post-injury (Step 3), and provides a referral and warm handoff to mental health services if needed (Step 4)

Group II: Enhanced Usual Care Condition Active Control 1 Intervention

Patients in the EUC arm will be given education about mental health after traumatic injury, educational materials about mental health recovery, and local referral information to assist treatment-seeking patients in seeking care.

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

George Washington University

Collaborator

Trials

263

Recruited

476,000+

Agency for Healthcare Research and Quality (AHRQ)

Collaborator

Trials

415

Recruited

6,777,000+

Findings from Research

In a study involving 116 PTSD patients, both Brief Eclectic Psychotherapy (BEP) and Eye Movement Desensitization and Reprocessing (EMDR) therapy led to significant increases in posttraumatic growth, indicating that these therapies not only help reduce PTSD symptoms but also promote positive personal development.

The research found that greater reductions in PTSD symptoms were associated with greater increases in posttraumatic growth, suggesting a relationship between symptom improvement and personal growth, although no specific treatment was found to predict these outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Turning wounds into wisdom: Posttraumatic growth over the course of two types of trauma-focused psychotherapy in patients with PTSD. Nijdam, MJ., van der Meer, CAI., van Zuiden, M., et al.[2018]

The Trauma Recovery Project study, involving 1,048 trauma patients, found that functional limitations persisted significantly at 12 and 18 months post-injury, with mean Quality of Well-Being scores remaining below the healthy norm, indicating a long-term impact on quality of life after major trauma.

Factors such as postinjury depression, PTSD, serious extremity injuries, and the number of days spent in the intensive care unit were identified as significant predictors of poor functional outcomes, highlighting the need for comprehensive post-trauma care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. Holbrook, TL., Anderson, JP., Sieber, WJ., et al.[2022]

The PTSD Recovery Program, which includes group therapy alongside individual therapy and medication, was effectively used to treat PTSD in 18 refugees over 10 weekly sessions, showing positive outcomes based on pre- and post-intervention questionnaires.

Qualitative data from participants indicated symptom improvement, and providers reported high satisfaction with the program, supporting its efficacy as an adjunctive treatment for PTSD in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using a Veterans Affairs Posttraumatic Stress Disorder Group Therapy Program With Refugees. Haefner, J., Abedi, M., Morgan, S., et al.[2019]

In a Level II trauma center, 86% of adult trauma patients enrolled in the Trauma Resilience and Recovery Program (TRRP), indicating strong initial engagement despite fewer resources compared to Level I centers.

However, only 30% of patients completed mental health screenings during follow-up, suggesting a need for program adaptations to enhance ongoing engagement and address mental health needs more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of a stepped care program to address posttraumatic stress disorder and depression in a Level II trauma center. Espeleta, HC., Litvitskiy, NS., Higgins, K., et al.[2023]

In a study of 172 patients with PTSD at a trauma center, those with private insurance, a high school diploma or higher, and more severe PTSD symptoms were more likely to participate in Trauma Recovery Services (TRS) programming, which aims to reduce PTSD symptoms and improve patient satisfaction.

Patients living further away from the TRS location were less likely to participate, suggesting that reducing travel distance could enhance participation in psychosocial programs for PTSD recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors influencing participation in psychosocial programming among orthopaedic trauma patients with PTSD. Furdock, RJ., Feldman, B., Sinkler, M., et al.[2022]

The Trauma Resilience and Recovery Program (TRRP) successfully engaged 96% of families approached, providing a structured approach to address the mental health needs of pediatric patients after hospitalization for injuries, with a focus on PTSD and depression.

Among families enrolled, 35.5% reported clinically significant PTSD and/or depression symptoms, and 76% of those with significant symptoms agreed to receive treatment, indicating the program's effectiveness in identifying and addressing mental health issues post-injury.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trauma Resilience and Recovery Program: Addressing Mental Health in Pediatric Trauma Centers. Ridings, LE., Anton, MT., Winkelmann, J., et al.[2022]

The Trauma Resiliency Model (TRM) is a unique therapy for trauma that focuses on body awareness and emotion regulation through nine specific skills, suggesting it may be more effective than traditional cognitive therapies.

While research on somatic therapies like TRM is limited, the approach is supported by neuroscience, indicating that understanding trauma responses biologically can help individuals process trauma more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Trauma Resiliency Model: A "Bottom-Up" Intervention for Trauma Psychotherapy. Grabbe, L., Miller-Karas, E.[2019]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Turning wounds into wisdom: Posttraumatic growth over the course of two types of trauma-focused psychotherapy in patients with PTSD. [2018]

2. United States pubmed.ncbi.nlm.nih.gov

Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Using a Veterans Affairs Posttraumatic Stress Disorder Group Therapy Program With Refugees. [2019]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Implementation of a stepped care program to address posttraumatic stress disorder and depression in a Level II trauma center. [2023]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Factors influencing participation in psychosocial programming among orthopaedic trauma patients with PTSD. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Trauma Resilience and Recovery Program: Addressing Mental Health in Pediatric Trauma Centers. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

The Trauma Resiliency Model: A "Bottom-Up" Intervention for Trauma Psychotherapy. [2019]