Trauma-focused Psychotherapy for PTSD and HIV
(TFPP-PLWH Trial)
Recruiting in Palo Alto (17 mi)
Overseen byBarbara Milrod, MD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Montefiore Medical Center
Must be taking: Psychotropic medications
Disqualifiers: Psychosis, Bipolar I, Substance use, others
No Placebo Group
Trial Summary
What is the purpose of this trial?People living with HIV (PLWH) have a higher rate of post-traumatic stress disorder (PTSD) diagnosis than the general population. Comorbid PTSD is also associated with negative HIV-related health outcomes. Unfortunately, little outcome research has examined the usefulness of PTSD treatments for PTSD. This pilot study adapts for PLWH a non-exposure based psychotherapy for PTSD focused on reflecting on one's emotions and relationships and understanding and working through how trauma may have disrupted them. The study team is interested in better understanding the needs of PLWH with PTSD, learning whether PLWH with PTSD find this treatment acceptable and helpful, and beginning to understand the relationship between HIV-related health factors (e.g., inflammation and stress biology) and PTSD, and how these health factors may improve during treatment.
Will I have to stop taking my current medications?
The trial requires that you stay on your current psychiatric or psychotropic medications if they have been stable for at least 2 months.
What data supports the effectiveness of the treatment Trauma-focused psychodynamic psychotherapy (TFPP) for PTSD and HIV?
Research shows that Trauma-focused psychodynamic psychotherapy (TFPP) has been used effectively for PTSD in various populations, including veterans and LGBTQ individuals, by addressing emotional and psychological impacts of trauma. While specific studies on TFPP for PTSD and HIV are not available, its success in treating PTSD in other groups suggests potential benefits.
12345Is trauma-focused psychodynamic psychotherapy (TFPP) safe for humans?
The available research on trauma-focused psychodynamic psychotherapy (TFPP) for PTSD, including studies with veterans and LGBTQ individuals, does not report any specific safety concerns, suggesting it is generally safe for humans.
12678How is Trauma-focused Psychodynamic Psychotherapy (TFPP) different from other treatments for PTSD?
Trauma-focused Psychodynamic Psychotherapy (TFPP) is unique because it is a brief, manualized therapy that focuses on attachment and emotions, and it explicitly considers identity-related and societal factors, which can be particularly beneficial for individuals facing minority stress, such as LGBTQ patients.
12579Eligibility Criteria
This trial is for people living with HIV who also have PTSD. Participants must have a confirmed diagnosis of PTSD with a certain severity score and be on stable psychiatric medication for at least two months, which will continue during the study.Inclusion Criteria
I have been diagnosed with HIV.
My mental health medication has been stable for 2 months and will continue.
I have been diagnosed with PTSD and my severity score is 25 or higher.
Exclusion Criteria
Acute suicidality
Current substance use disorder
Organic mental syndrome or intellectual disability
+3 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive trauma-focused psychodynamic psychotherapy twice-weekly for 24 sessions
12 weeks
24 visits (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment
3 months
Participant Groups
The trial is testing trauma-focused psychodynamic psychotherapy, a type of therapy that helps patients reflect on emotions and relationships affected by trauma without directly exposing them to traumatic memories.
1Treatment groups
Experimental Treatment
Group I: Trauma-focused psychodynamic psychotherapyExperimental Treatment1 Intervention
Twice-weekly psychotherapy for 24 sessions
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Albert Einstein College of MedicineBronx, NY
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Who Is Running the Clinical Trial?
Montefiore Medical CenterLead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)Collaborator
References
Trauma-Focused Psychodynamic Psychotherapy of a Patient With PTSD in a Veterans Affairs Setting. [2019]This article aims to articulate the use of trauma-focused psychodynamic psychotherapy (TFPP) for a 33-year-old U.S. Army veteran with posttraumatic stress disorder (PTSD) in a Veterans Affairs (VA) setting.
Open Trial of Trauma-Focused Psychodynamic Psychotherapy for Posttraumatic Stress Disorder Among LGBTQ Individuals. [2023]Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals report higher rates of exposure to traumatic events and posttraumatic stress disorder (PTSD) compared with heterosexual and cisgender individuals. No treatment outcomes research has focused on PTSD in the LGBTQ population. Trauma-focused psychodynamic psychotherapy (TFPP) is a brief, manualized, attachment- and affect-focused psychotherapy for PTSD. TFPP explicitly incorporates broad identity-related and societal factors into its conceptualization of trauma and its consequences, which may be especially helpful for LGBTQ patients with minority stress who seek affirmative care.
The place of psychodynamic psychotherapy in the integrated treatment of posttraumatic stress disorder and trauma recovery. [2011]Psychodynamic psychotherapists treating posttraumatic stress disorder (PTSD) sufferers can draw on an accumulated body of trauma studies from their own field to guide their work. However, these reports, often based on case studies or conceptual reviews, do not have the same empirical conclusiveness as more recent evidence-based research demonstrating the efficacy of cognitive-behavioral and body-oriented therapies. In this article, a psychodynamic psychotherapist reflects on his treatment of an Israeli man who developed PTSD after enduring 4 terrorist attacks. The author shows how assimilative integration offered him a theory- and research-based model that helped him comfortably combine separate treatment interventions. He also shows how this model helped him locate with some precision the specific contribution of psychodynamic psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Trauma-Focused Psychodynamic Psychotherapy. [2019]The authors describe a psychodynamic psychotherapeutic approach to posttraumatic stress disorder (PTSD), trauma-focused psychodynamic psychotherapy. This psychotherapy addresses disruptions in narrative coherence and affective dysregulation by exploring the psychological meanings of symptoms and their relation to traumatic events. The therapist works to identify intrapsychic conflicts, intense negative affects, and defense mechanisms related to the PTSD syndrome using a psychodynamic formulation that provides a framework for intervention. The transference provides a forum for patients to address feelings of mistrust, difficulties with authority, fears of abuse, angry and guilty feelings, and fantasies.
[Trauma-focused Cognitive-behavioral Therapy with children and adolescents: Practice, evidence base, and future directions]. [2018]Trauma-focused cognitive behavioral therapy (Tf-CBT) is an evidence-based trauma therapy for children and adolescents aged 3–17 years with posttraumatic stress disorder (PTSD). One supportive caregiver is regularly included in the therapeutic process. Tf-CBT consists of eight components and can be summarized by the acronym P.R.A.C.T.I.C.E: Psychoeducation and Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Based on a total of 13 randomized controlled trials, several meta-analyses and systematic reviews confirm the efficacy of Tf-CBT, which received evidence level Ia in several international guidelines and is therefore recommended as first-line treatment for children and adolescents with PTSD.
Future directions for interventions targeting PTSD in HIV-infected adults. [2018]Although studies consistently report high rates of comorbid posttraumatic stress disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the three existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found two empirically supported cognitive-behavioral therapy-based interventions for the treatment of trauma-related symptoms in HIV-infected adults. Due to the continued limited number of effective interventions for this population, a second aim of our review was to draw from the expansive field of effective PTSD interventions for the general population to propose ways that future clinical intervention research may be tailored for HIV-infected adults. Therefore, in addition to a review, we conceptualized this paper as an opportunity to generate an ideal preview of the field of intervention research in this population.
Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence. [2022]Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base.
Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: A Randomized Controlled Trial in Eight German Mental Health Clinics. [2022]Trauma-focused cognitive behavioral therapy (Tf-CBT) is efficacious for children and adolescents with posttraumatic stress symptoms (PTSS). Its effectiveness in clinical practice has still to be investigated.
Trauma-focused treatments for depression. A systematic review and meta-analysis. [2021]Trauma-focused treatments (TFTs) have demonstrated efficacy at decreasing depressive symptoms in individuals with PTSD. This systematic review and meta-analysis evaluated the effectiveness of TFTs for individuals with depression as their primary concern.