November 23, 2016
2 min read

Individual cognitive therapy more effective than group therapy for PTSD

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Cognitive processing therapy administered individually was more effective than therapy administered in a group for PTSD among active-duty service members who developed PTSD postdeployment, according to recent findings.

“PTSD is a serious problem among active-duty military personnel, especially those returning from a combat deployment. However, little research has been done on the treatment of PTSD in active-duty military,” Patricia A. Resick, PhD, of Duke University Medical Center, Durham, North Carolina, and colleagues wrote. “Cognitive processing therapy (CPT) is an evidenced-based, trauma-focused cognitive therapy for PTSD that has been found to be efficacious in civilian and veteran randomized clinical trials, with long-lasting results for 5 to 10 years among civilians.”

To compare effects of CPT administered in individual or group settings on PTSD and co-occurring symptoms, researchers conducted a randomized clinical trial among 268 active-duty service members with PTSD after deployment who achieved stability with medication. Study participants were randomly assigned to receive CPT in 90-minute group sessions of eight to 10 participants (n = 133) or 60-minute individual sessions (n = 135) twice weekly for 6 weeks. The cohort had a mean age of 33.2 years.

Participants who received CPT individually exhibited greater improvement in PTSD severity with a mean difference in Posttraumatic Symptom Scale-Interview Version (PSS-I) scores of –3.7 (P = .006), compared with those who received group CPT.

Charles W. Hoge
Charles W. Hoge

Significant improvements in PSS-I and stressor-specific Posttraumatic Stress Disorder Checklist scores were maintained among individual and group CPT participants, with no differences in remission or PTSD severity at 6-month follow-up.

Depression and suicidal ideation symptoms did not significantly differ between treatment groups, according to researchers.

“These findings point to the ongoing crisis in PTSD care for service members and veterans. Despite the large increase in availability of evidence-based treatments, considerable room exists for improvement in treatment efficacy, and satisfaction appears bleak based on low treatment retention,” Charles W. Hoge, MD, of Walter Reed Army Institute of Research, Silver Spring, Maryland, and colleagues wrote in an accompanying editorial. “This trial by Resick et al reflects how far PTSD research has evolved, but also highlights that we have probably come about as far as we can with currently dominant clinical approaches. Other strategies are urgently needed to effectively address remaining research and clinical gaps concerning the health care needs of combat veterans.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.