Integrated Therapies for PTSD

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Palo Alto Veterans Institute for Research

No Placebo Group

Trial Summary

What is the purpose of this trial?

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.

Research Team

Eligibility Criteria

This trial is for firefighters aged 18-65 with posttraumatic stress symptoms, insomnia, and nightmares. They must speak English and have a certain level of PTSD severity (CAPS-5 score ≥ 25), frequent nightmares (at least once a month), and significant insomnia (ISI ≥ 15). Those at risk of harming themselves or others, unable to understand the questionnaires, using alcohol during treatment, or with serious mental health conditions like bipolar disorder or psychosis cannot join.

Inclusion Criteria

I am between 18 and 65 years old.

Firefighter

Able to speak and read English

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Exclusion Criteria

Current suicide or homicide risk meriting crisis intervention

Inability to comprehend the baseline screening questionnaires

Unwilling to remain abstinent from alcohol during treatment

See 2 more

Treatment Details

Interventions

Cognitive Behavioral Therapy for Insomnia (CBTi) (Behavioural Intervention)
Cognitive Behavioral Therapy for Nightmares (CBTn) (Behavioural Intervention)
Waitlist (Behavioural Intervention)
Written Exposure Therapy (WET) (Behavioural Intervention)

Trial OverviewThe study tests an integrated behavioral therapy combining Written Exposure Therapy (WET) with Cognitive Behavioral Therapies for Insomnia (CBTi) and Nightmares (CBTn). It checks if this approach is workable, acceptable, and effective compared to delayed treatment. Participants will undergo group sessions over four days followed by a booster session and assessments before, during after treatment as well as three months later.

Participant Groups

2Treatment groups

Experimental Treatment

Active Control

Group I: Immediate InterventionExperimental Treatment3 Interventions

Will begin treatment within 2 weeks of randomization.

Group II: Delayed InterventionActive Control1 Intervention

Will be scheduled to begin treatment within 4-6 weeks of randomization.