Adaptive Decision-making And Personalized Treatment for PTSD (ADAPT-PTSD)

Summary

By doing this research project, the investigators hope to learn which strategies work best to help veterans who are not benefiting from their first PTSD treatment or not completing between-session homework assignments regularly that might improve treatment response. The investigators also want to learn how best to match the right type and amount of treatment to each individual veteran. By conducting this research project, they hope to:

* See if trying a different treatment strategy for veterans not responding to their first PTSD treatment would be more helpful
* See if sending text message prompts between sessions encourages more completion of between-session homework

Conditions

• Posttraumatic Stress Disorder
• PTSD

Interventions

BEHAVIORAL

Modular Cognitive Processing Therapy

CPT is a first-line treatment for PTSD that includes the following core elements: (a) identification of "stuck points" in thinking that interfere with recovery and (b) using Socratic questioning and a series of Contains the same core elements of CPT, but content is repackaged into modules instead of sessions so that clinicians can select and dose treatment elements according to patient need. Modular CPT contains the same core elements of CPT, but content is repackaged into modules instead of sessions so that clinicians can select and dose treatment elements according to patient need.

BEHAVIORAL

Modular Prolonged Exposure Therapy

PE is a first-line treatment for PTSD that includes the following core elements: (a) in vivo exposure and (b) imaginal exposure to the trauma memory. Modular PE is comprised of the same elements of standard PE, but clinicians select and dose modules (i.e., imaginal exposure, in vivo exposure) based on individual patient need.

BEHAVIORAL

Step Down Treatment

Self-managed treatment will involve receiving a self-help version of the remaining treatment materials and ongoing use of the intervention companion app (CPT Coach or PE Coach).

BEHAVIORAL

Digital Interventions

The prompt will be a text message delivered through VA-approved technology (e.g., PETALS).

BEHAVIORAL

Cognitive Processing Therapy (CPT)

CPT is a first-line treatment for PTSD that includes the following core elements: (a) identification of "stuck points" in thinking that interfere with recovery and (b) using Socratic questioning and a series of progressive worksheets to examine stuck points, develop balanced beliefs, and facilitate the experience of natural emotions.

BEHAVIORAL

Prolonged Exposure (PE)

PE is a first-line treatment for PTSD that includes the following core elements: (a) in vivo exposure and (b) imaginal exposure to the trauma memory. In imaginal exposure, participants repeatedly, systematically approach their trauma memory and related thoughts and feelings. In in vivo exposure, participants repeatedly, systematically approach objectively safe people, places, objects, and situations that they avoid because these stimuli remind them of their trauma.

Sponsors & Collaborators

• United States Department of Defense

  collaborator FED

• The University of Texas Health Science Center at San Antonio

  lead OTHER

Principal Investigators

• Stefanie LoSavio, PhD · The University of Texas Health Science Center at San Antonio

• Rebecca Sripada, PhD · VA Ann Arbor-506

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-12-12

Primary Completion

2028-05-22

Completion

2028-08-14

Countries

• United States

Study Locations