Two Stepped Care Models for Posttraumatic Stress Disorder (PTSD) Among Cambodian Refugees With PTSD

This project aims to investigate the efficacy of two models to treat PTSD for Cambodian
refugees in primary care. The first step in both models is giving a medication (an
SSRI/SSRN, e.g., paroxetine). For those who still have PTSD, the second step is either
adding another medication (e.g., prazosin) or providing culturally sensitive cognitive
behavioral therapy (CBT). We hypothesize that patients will improve in both models, but more
so in the the CBT model. The primary outcome measure is PTSD severity as assessed by the
PTSD Checklist (PCL). Eligibility requirements include having PTSD and having been old
enough to remember the Khmer Rouge period.

Inclusion Criteria:

- PTSD;

- PCL great or equal to 44;

- Survivor of the Cambodian genocide;

- At least 7 years old at the time of the Cambodian genocide

Exclusion Criteria:

- Pregnant;

- Active suicidality;

- Mental retardation;

- Organic mental disorder;

- Bipolar disorder;

- Alcohol dependence;

- Marijuana dependence;

- Unable to give conformed consent