Post traumatic stress disorder (PTSD) is a serious problem among active-duty military personnel,
especially those returning from combat deployment. More data are needed
on the efficacy of individual and group therapy treatment for
published online by JAMA Psychiatry
suggests that individual sessions of cognitive processing therapy (CPT) - a
trauma-focused treatment that teaches patients more balanced thinking
about traumatic events - were better at reducing the severity of
post traumatic stress disorder in active-duty military members,
although group sessions also were effective.
‘Cognitive processing therapy (CPT) delivered in an individual format was more efficacious in treating symptoms of post traumatic stress disorder (PTSD) compared with CPT delivered in a group format.’
Patricia A. Resick of the Duke University Medical Center,
Durham, N.C., and coauthors conducted a randomized clinical trial of 268
active-duty personnel seeking treatment for PTSD at Fort Hood, Texas,
after being deployed near Iraq or Afghanistan. The participants were
nearly all men (91%) with an average age of 33.
The participants were assigned to CPT in either 90-minute group
sessions (n=133 participants) or 60-minute individual sessions (n=135
participants) twice weekly for six weeks. The 12 sessions (group and
individual) were conducted concurrently. Assessment tools were used to
measure PTSD severity, as well as the secondary outcomes of depression
and suicidal ideation.
The authors report greater improvement in PTSD severity when
participants received CPT in individual compared with group sessions,
although improvements were maintained during the six-month follow-up in
both groups, according to the results. Patients assigned to individual
CPT had about twice as much improvement.
Depression and suicidal ideation improved equally with both forms of
CPT. Still, about 50% of the participants, including those
receiving individual CPT, still had PTSD and significant symptoms.
Possible explanations for why patients in individual CPT may have
fared better include that those in group received less individual
attention and those who missed group CPT sessions missed content that
could not be replaced, the authors report.
Limitations to the study include patients lost to treatment because of military discontinuation.
"Cognitive processing therapy delivered in an individual format was
more efficacious in treating symptoms of PTSD compared with CPT
delivered in a group format. Significant reductions in PTSD were
maintained during a six-month follow-up. To our knowledge, these
findings are the strongest to date with regard to existing treatments
for PTSD in active-duty military and veterans, but more work is required
to improve outcomes," the study concludes.