Intensive Couple Therapy for PTSD

Overseen By Alan L Peterson, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Penn State University

Disqualifiers: Suicidal ideation, Homicide risk, Alcohol misuse, Manic episode, Psychotic disorder, Traumatic brain injury, others

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

Compensation: Varies

Number of Visits: 2

Duration: 2 days

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new therapy approach called AIM-CBCT for PTSD (Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy for PTSD), designed to assist military members and veterans with post-traumatic stress disorder. The researchers aim to determine if this therapy improves PTSD symptoms, depression, and relationship satisfaction. Participants will attend a two-day retreat to learn skills that reduce PTSD symptoms and enhance their relationships. This new therapy will be compared to a relationship education program to assess which is more effective. Service members or veterans with PTSD who have lived with their partner for at least three months might be suitable for this trial. As an unphased trial, this study provides a unique opportunity to explore innovative therapy methods that could significantly enhance well-being and relationship satisfaction.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, if you are currently participating in certain PTSD treatments, you may not be eligible to join the trial.

What prior data suggests that AIM-CBCT for PTSD is safe for participants?

Research shows that cognitive-behavioral conjoint therapy (CBCT) for PTSD is generally safe for participants. Studies have found that this therapy reduces PTSD symptoms and improves relationships without causing significant side effects. It helps couples work together to manage PTSD, and most find it manageable.

In past research, veterans and their partners who tried CBCT reported improvements in PTSD symptoms and relationship satisfaction. No major harmful side effects were reported, indicating that the therapy is a safe option for couples managing PTSD together.

Overall, CBCT for PTSD is a safe and effective treatment, making it a promising choice for those considering joining a clinical trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for PTSD because they offer a unique approach compared to standard individual therapies like prolonged exposure or cognitive processing therapy. The Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy (AIM-CBCT) focuses on healing within a relationship context, emphasizing the power of partnership and support in recovery. This method is delivered in a multi-couple group setting, potentially fostering a community of shared experiences and mutual encouragement. Additionally, the Prevention and Relationship Education Program (PREP) supports couples by enhancing communication and relationship skills, which can be crucial for managing PTSD symptoms together. Both approaches highlight the role of relationships in mental health, offering a fresh perspective on treatment.

What evidence suggests that AIM-CBCT for PTSD could be an effective treatment for PTSD?

Research shows that cognitive-behavioral conjoint therapy (CBCT) for PTSD reduces PTSD symptoms and improves relationships in veterans. Studies have found that working with multiple couples simultaneously can quickly enhance both personal and relationship well-being. This trial will compare the Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy for PTSD (AIM-CBCT for PTSD) with the Prevention and Relationship Education Program (PREP), a standard relationship education program, to determine if AIM-CBCT offers additional benefits. AIM-CBCT not only lessens PTSD symptoms but also addresses related issues like depression and stress between partners. Early results suggest improvements in couples' satisfaction and overall relationship quality. ^{1 2 3 6 7}

Who Is on the Research Team?

Steffany J Fredman, Ph.D.

Principal Investigator

Penn State University

Are You a Good Fit for This Trial?

This trial is for military service members or veterans with PTSD and their romantic partners who are willing to participate. Couples must be married or cohabiting for at least three months, speak English, and one partner must have a confirmed PTSD diagnosis with significant symptoms.

Inclusion Criteria

Couple is married or cohabiting for at least 3 months

Both partners able to speak and read English

Service member or veteran and a romantic partner willing to participate

Exclusion Criteria

Either person in the study is currently having thoughts of hurting themselves and needs immediate help.

Either you or your partner have experienced a serious head injury or have difficulty thinking or remembering things.

Couple is separated or have taken steps to dissolve their relationship

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants attend a two-day retreat for AIM-CBCT for PTSD or PREP, practicing skills to decrease PTSD symptoms and enhance relationships

2 days

1 visit (in-person)

Follow-up

Participants are monitored for PTSD symptoms, depression, anxiety, anger, and relationship satisfaction

6 months

Follow-up assessments at 1-month, 3-month, and 6-month intervals

What Are the Treatments Tested in This Trial?

Interventions

• Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy for PTSD
• Prevention and Relationship Education Program

Trial Overview The study tests an intensive therapy called AIM-CBCT for PTSD against the Prevention and Relationship Education Program (PREP). Both programs involve a two-day retreat where couples learn skills to manage PTSD symptoms and improve their relationship.

How Is the Trial Designed?

Group I: Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy for PTSD Experimental Treatment 1 Intervention

AIM-CBCT for PTSD is an abbreviated, intensive, multi-couple group version of cognitive-behavioral conjoint therapy for PTSD, an evidence-based treatment for PTSD delivered in a conjoint format.

Group II: Prevention and Relationship Education Program Active Control 1 Intervention

PREP is an evidence-based relationship education program delivered in a multi-couple group format.

Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy for PTSD is already approved in United States, European Union for the following indications:

Approved in United States as CBCT for PTSD for:

• Posttraumatic Stress Disorder (PTSD)
• Improvement of relationship functioning in couples where one partner has PTSD

Approved in European Union as CBCT for PTSD for:

• Posttraumatic Stress Disorder (PTSD)
• Improvement of relationship functioning in couples where one partner has PTSD

Who Is Running the Clinical Trial?

Penn State University

Lead Sponsor

Trials

380

Recruited

131,000+

University of Denver

Collaborator

Trials

25

Recruited

10,600+

Toronto Metropolitan University

Collaborator

Trials

95

Recruited

19,300+

The University of Texas Health Science Center at San Antonio

Collaborator

Trials

486

Recruited

92,500+

Published Research Related to This Trial

In a randomized controlled trial with 40 individuals with PTSD and their partners, cognitive-behavioral conjoint therapy (CBCT) for PTSD led to significant improvements in all PTSD symptom clusters and trauma-related beliefs compared to a waitlist group.

The study highlights the effectiveness of a couple-based approach in treating PTSD, with improvements measured by clinician ratings and patient-reported cognitions, indicating that CBCT can be a valuable treatment option for enhancing relationship functioning in those affected by PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial. Macdonald, A., Pukay-Martin, ND., Wagner, AC., et al.[2018]

In a pilot study involving seven couples, present-focused cognitive-behavioral conjoint therapy (CBCT) for PTSD led to significant reductions in PTSD symptoms, with medium-to-large effect sizes, indicating its potential effectiveness.

While relationship satisfaction improved for partners, the changes were only significant for them, suggesting that CBCT may be particularly beneficial for partners of individuals with PTSD, especially for those hesitant to pursue trauma-focused treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An uncontrolled trial of a present-focused cognitive-behavioral conjoint therapy for posttraumatic stress disorder. Pukay-Martin, ND., Torbit, L., Landy, MS., et al.[2018]

In a study of 37 patients undergoing cognitive-behavioral conjoint therapy (CBCT) for PTSD, pre-treatment relationship satisfaction did not predict treatment drop-out or changes in PTSD symptoms, suggesting that these factors are independent of each other.

However, couples who started treatment in distressed relationships experienced greater improvements in relationship satisfaction compared to those who were already satisfied, indicating that CBCT may be particularly beneficial for couples facing relationship challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Preliminary Examination of the Effects of Pretreatment Relationship Satisfaction on Treatment Outcomes in Cognitive-Behavioral Conjoint Therapy for PTSD. Shnaider, P., Pukay-Martin, ND., Sharma, S., et al.[2020]

Cognitive behavioral conjoint therapy (CBCT) for PTSD significantly reduced veterans' PTSD symptoms (effect size d = -0.69) and improved relationship happiness for both veterans and their partners during a 15-session treatment in a sample of 113 couples from a VA clinic.

In addition to PTSD symptom reduction, CBCT also enhanced relationship satisfaction and decreased depressive symptoms for both veterans and their partners, indicating its effectiveness in improving overall mental health and relationship functioning in real-world settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic. Pukay-Martin, ND., Fredman, SJ., Martin, CE., et al.[2023]

Cognitive-behavioral conjoint therapy (CBCT) for PTSD is structured in three phases, focusing on improving PTSD symptoms and enhancing relationship satisfaction through psychoeducation, behavioral methods, and addressing trauma-related cognitions.

The therapy emphasizes the importance of couples working together to confront fears and improve their relationship, which can lead to better outcomes for both PTSD symptoms and relationship functioning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder: application to a couple's shared traumatic experience. Brown-Bowers, A., Fredman, SJ., Wanklyn, SG., et al.[2018]

A pilot study involving 24 couples, where at least one partner was a veteran or active-duty service member with PTSD, showed that an abbreviated, intensive multi-couple group therapy (AIM-CBCT for PTSD) delivered over a single weekend significantly reduced PTSD symptoms and improved relationship satisfaction.

Participants experienced substantial improvements in various mental health symptoms, including PTSD, depression, and anxiety, with effects lasting up to three months after the intervention, indicating that this format may enhance engagement and retention in therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads. Fredman, SJ., Macdonald, A., Monson, CM., et al.[2021]

Cognitive-behavioral conjoint therapy (CBCT) for PTSD is designed to address both posttraumatic stress disorder and relationship distress, filling a gap in evidence-based treatments for veterans returning from duty.

The paper highlights the strong link between PTSD and relationship problems, emphasizing the need for integrated therapies like CBCT to support veterans and their partners effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder: application to operation enduring and Iraqi Freedom veterans. Monson, CM., Fredman, SJ., Adair, KC.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9035020/

Effectiveness of cognitive behavioral conjoint therapy for ... The findings suggest that CBCT for PTSD was effective for decreasing PTSD and comorbid symptoms in veterans, as well as for improving relationship functioning ...

2. ptsd.va.gov ptsd.va.gov/professional/articles/article-pdf/id1549472.pdf

Intensive, Multi-Couple Group Therapy for PTSD Delivering CBCT for PTSD through an abbreviated, intensive multi-couple group format may be an efficient strategy for improving patient, partner, and relational ...

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S000578941930125X

Intensive, Multi-Couple Group Therapy for PTSD This nonrandomized trial was designed to pilot an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) delivered over a ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10760895/

PMC - PubMed Central A closer examination of relational outcomes from a pilot study of abbreviated, intensive, multi-couple group cognitive-behavioral conjoint therapy for PTSD ...

5. jamanetwork.com jamanetwork.com/journals/jama/fullarticle/1346190

Effect of Cognitive-Behavioral Couple Therapy for PTSD A disorder-specific couple therapy, compared with a wait list for the therapy, resulted in decreased PTSD symptom severity and patient comorbid symptom ...

6. strongstar.org strongstar.org/research/strongstar/randomized-controlled-trial-of-intensive-multi-couple-group-therapy-for-ptsd-vers/

Randomized Controlled Trial of Intensive Multi-Couple ... Test an abbreviated, intensive, multi-couple group version of Cognitive-Behavioral Conjoint Therapy for PTSD in comparison to an established couples ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S2451865418301571

Design of a randomized superiority trial of a brief couple ... This study is the first RCT designed to investigate the delivery of B-CBCT specifically to veterans with PTSD and their partners.