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Group treatment reduces veterans’ PTSD symptom severity

Both group cognitive behavioral treatment and group present-centered treatment reduced PTSD symptom severity in veterans with PTSD, according to study findings.

“Relative to individual treatment approaches, there has been much less research conducted on PTSD group treatments,” Denise M. Sloan, PhD, professor of psychiatry at Boston University School of Medicine and behavioral science division associate director at the National Center for PTSD, and colleagues wrote. “The majority of studies investigating PTSD group treatment have used an open trial design, which provides limited information about treatment efficacy.”

Sloan and colleagues conducted a randomized controlled trial comparing the efficacy of a group CBT with group present-centered treatment among veterans with chronic PTSD.

Core features of group CBT included psychoeducation, in vivo and written exposure, progressive muscle relaxation, cognitive restructuring of post-trauma dysfunctional thoughts, assertion training, behavioral activation and preventing symptom recurrence. Group present-centered treatment focused on psychoeducation, peer support and fostering peer-facilitated problem solving.

Participants were randomly assigned to receive 14 two-hour sessions of either group CBT (n = 98) or group present-centered treatment (n = 100). Researchers assessed PTSD via the Clinician-Administered PTSD Scale for DSM-5, as well as PTSD symptom severity, depression, anxiety, and functional impairment at baseline, midtreatment, post-treatment, and 3-, 6-, and 12-month follow-ups.

The researchers found no significant differences between group CBT and group present-centered treatment. Participants in both groups demonstrated significant decreases in PTSD symptom severity at posttreatment, which remained at 12 months following treatment completion, according to the results. However, about 70% of participants still met PTSD diagnostic criteria after treatment, and less than 40% of veterans in both conditions showed reliable symptom decreases.

Participants in both groups experienced significant decreases in depression symptoms, anxiety symptoms and functional impairment. In addition, the investigators observed reductions in the percentage of participants who met diagnostic status for co-occurring major depression disorder and generalized anxiety disorder after treatment in both study groups. Participants also reported high levels of treatment satisfaction.

“The study adds to the growing literature that shows smaller effect sizes for trauma-focused group treatment relative to trauma-focused treatment delivered individually,” Sloan and colleagues wrote. “Given the small number of [randomized controlled trials] that have examined group PTSD treatment, it will be important to continue to investigate group treatment approaches for PTSD given the potential cost-effectiveness of this approach and the need to provide quality care for large numbers of veterans and active-duty service members seeking PTSD treatment.” – by Savannah Demko

Disclosures: This study was funded by Department of Veteran Affairs Merit awarded to Sloan. One other author reports support from the NIMH.