An Efficient Treatment for Posttraumatic Injury for Firefighters

Summary

The goal of this two-arm pilot randomized controlled trial is to test a behavioral intervention that integrates three evidence-based cognitive behavioral interventions (written exposure therapy; WET, cognitive behavioral therapy for insomnia; CBT-I, and cognitive behavioral therapy for nightmares; CBT-N) among firefighters. The main questions it aims to answer are:

* Is the behavioral intervention feasible, acceptable, and effective in reducing symptoms of posttraumatic stress, insomnia, and nightmares?
* What is the efficacy of efficient treatment vs. delayed treatment (2-4 week waitlist) in reducing symptoms of posttraumatic stress, insomnia, and nightmares?

We will beta test the intervention in 1-2 groups of 3-5 firefighters. Then we will randomize 50 participants to immediate or delayed (2-4 week waitlist) treatment. Consented participants will:

* Complete self-report and interview measures assessing posttraumatic stress disorder, insomnia (PTSD), and nightmares
* Attend an individual treatment orientation session
* Attend a 4-day (\~3 hours per day over 4 consecutive days) group treatment that integrates WET, CBT-I, and CBT-N
* Attend an individual booster session held approximately one week later
* Complete self-report measures before, during, and after treatment, and at a 3-month follow up assessment and a clinical interview before and after treatment to assess program efficacy.

Conditions

• Posttraumatic Stress Disorder
• Insomnia
• Nightmare

Interventions

BEHAVIORAL

Written Exposure Therapy (WET)

WET is a trauma-focused intervention in which individuals write about their worst traumatic experience following scripted instruction from the therapist.

BEHAVIORAL

Cognitive Behavioral Therapy for Insomnia (CBTi)

CBTi focuses on stimulus control, eliminating maladaptive coping habits, reducing arousal, and challenging maladaptive thoughts about sleep in an effort to reduce time to fall asleep and time awake during the night.

BEHAVIORAL

Cognitive Behavioral Therapy for Nightmares (CBTn)

CBTn involves writing about a distressing or frequent nightmare, rewriting the narrative of the nightmare to target trauma-related themes, and reading the rescripted nightmare narrative.

BEHAVIORAL

Waitlist

Waitlist for delayed intervention.

Sponsors & Collaborators

• University of Arizona

  collaborator OTHER

• Oregon State University

  collaborator OTHER

• Boston University

  collaborator OTHER

• The University of Texas Health Science Center at San Antonio

  collaborator OTHER

• National Development and Research Institutes, Inc.

  collaborator OTHER

• Palo Alto Veterans Institute for Research

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-12-01

Primary Completion

2025-01-01

Completion

2025-01-01

Countries

• United States

Study Locations