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

Trial Summary

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 data supports the effectiveness of the treatment AIM-CBCT for PTSD?

Research shows that AIM-CBCT for PTSD, a therapy for couples, significantly reduces PTSD symptoms and improves relationship satisfaction. Studies with military and veteran couples found notable improvements in PTSD, depression, anxiety, and anger, as well as better relationship satisfaction after treatment. ^{1 2 3 4 5}

Is Intensive Couple Therapy for PTSD safe for humans?

Research on Cognitive-Behavioral Conjoint Therapy for PTSD, including its intensive and group formats, shows it is generally safe for humans, with studies reporting improvements in PTSD symptoms, depression, anxiety, and relationship satisfaction without significant safety concerns. ^{1 2 3 5 6}

How is the AIM-CBCT for PTSD treatment different from other PTSD treatments?

AIM-CBCT for PTSD is unique because it is an intensive, multi-couple group therapy that focuses on improving both PTSD symptoms and relationship satisfaction by involving both partners in the treatment process. It is delivered over a single weekend, making it a more efficient option compared to traditional, longer-term therapies. ^{1 2 3 5 7}

What is the purpose of this trial?

The goal of this clinical trial is to test an abbreviated, intensive, multi-couple group version of cognitive-behavioral conjoint therapy for PTSD (AIM-CBCT for PTSD) in an active military and veteran population. The main questions it aims to answer are: * Does AIM-CBCT for PTSD improve PTSD symptoms? * Does AIM-CBCT for PTSD improve associated symptoms (e.g., depression), romantic partner distress, and couple relationship satisfaction? Participants will participate in a two-day retreat in which they are taught and practice skills to decrease PTSD symptoms and enhance their relationships. Researchers will compare AIM-CBCT for PTSD to the Prevention and Relationship Education Program (PREP) to determine whether it is superior to an evidence-based relationship education curriculum that is also delivered in a two-day multi-couple group format.

Research Team

Steffany J Fredman, Ph.D.

Principal Investigator

Penn State University

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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 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]

References

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

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder: application to a couple's shared traumatic experience. [2018]

2. England pubmed.ncbi.nlm.nih.gov

Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads. [2021]

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

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder: application to operation enduring and Iraqi Freedom veterans. [2018]

4. United States 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. [2020]

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

Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic. [2023]

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

An uncontrolled trial of a present-focused cognitive-behavioral conjoint therapy for posttraumatic stress disorder. [2018]

7. United States 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. [2018]