Boston University College of Health & Rehabilitation Sciences:
Sargent College

Boston University College of Health & Rehabilitation Sciences: Sargent College

Cognitive Behavioral Treatment of PTSD in Severe Mental Illness

Funding:

NIMH

Dates:

2007 - 2011

Description

Trauma and posttraumatic stress disorder (PTSD) are common problems in the lives of persons with a serious mental illness and are associated with considerable distress and impairment in functioning. The cognitive-behavioral therapy (CBT) for PTSD program is a 12-16 week individual program, developed by Mueser and colleagues, which is the first standardized treatment for PTSD in this population shown to improve outcomes in controlled research. This program includes breathing retraining, psychoeducation about trauma and PTSD, and cognitive restructuring. Cognitive restructuring is a widely used approach throughout the CBT field for helping people deal with upsetting feelings, including feelings related to traumatic experiences. Cognitive restructuring involves teaching people how to identify the thought or belief underlying a negative feeling, evaluating the evidence for and against the upsetting thought, and changing the thought when it isn’t accurate (or making a plan to deal with the situation when the thought is accurate). This study builds on the success of the first randomized controlled trial of the CBT for PTSD program, in which the CBT program was found to improve PTSD and related outcomes more than usual services in clients with a serious mental illness living in New Hampshire or Vermont.

This study was completed at five sites in the University Behavioral Healthcare system at the University of Medicine and Dentistry of New Jersey. The findings extended previous research on this CBT for PTSD program by 1) having all treatment provided by frontline (e.g., masters level) clinicians (as opposed to academically trained doctoral-level clinicians used in the previous study), 2) focusing on predominantly minority clients with a serious mental illness and PTSD living in urban New Jersey, and 3) comparing the CBT program with a brief (3-session) program for PTSD that includes breathing retraining and psychoeducation.

A total of 201 clients with a serious mental illness and PTSD were randomly assigned to either the 12-16 session CBT for PTSD program or the 3-session brief program, with follow-up assessments conducted after treatment, and 6 and 12 months later. Statistical analyses tested the hypotheses that the CBT for PTSD program is more effective than the brief program at improving PTSD severity and diagnosis, other symptoms, quality of life, community functioning, as well as reducing the use of acute care services and direct treatment costs.

Investigators

Co-Investigator: Kim Meuser, Ph.D.
Co-Investigator: Jennifer Gottlieb, Ph.D.

Documents

Please see the following article for results of this project:

Mueser KT, Gottlieb JD, Xie H, Lu W, Yanos PT, Rosenberg SD, Silverstein SM,
Duva SM, Minsky S, Wolfe RS, McHugo GJ. (2015). Evaluation of cognitive restructuring for post-traumatic stress disorder in people with severe mental illness. British Journal of Psychiatry. 206(6),501-8.
https://www.ncbi.nlm.nih.gov/pubmed/25858178

Contact

Inquiries related to the project should be addressed to:

Kim Mueser
mueser@bu.edu
Boston University, Center for Psychiatric Rehabilitation
940 Commonwealth Avenue West, 2nd Floor
Boston, MA 02215