Peer Social Support During In Vivo Exposure for PTSD
| Status: | Recruiting |
|---|---|
| Conditions: | Anxiety, Psychiatric, Psychiatric, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 7/21/2018 |
| Start Date: | May 1, 2018 |
| End Date: | December 2019 |
| Contact: | Wendy Muzzy, MRA,MLIS |
| Email: | muzzy@musc.edu |
| Phone: | 843-792-8068 |
Peer Social Support During In Vivo Exposure for PTSD: A Program to Address Dropout From Prolonged Exposure
Veterans who have prematurely dropped out of exposure therapy for PTSD will be contacted and
offered the opportunity to return to treatment, this time with the assistance of an in vivo
exposure therapy 'workout buddy'. This peer will meet them at the in vivo exposure therapy
location and offer support an encouragement while the patient remains in that location. As
the PTSD treatment standards in Charleston and other VA sites across the country increasingly
include telemedicine delivered care, both in person and telemedicine based exposure therapy
recipients will be included. There will be no randomization; all participants will receive
the peer support 'workout buddy' for exposure therapy assignments.
offered the opportunity to return to treatment, this time with the assistance of an in vivo
exposure therapy 'workout buddy'. This peer will meet them at the in vivo exposure therapy
location and offer support an encouragement while the patient remains in that location. As
the PTSD treatment standards in Charleston and other VA sites across the country increasingly
include telemedicine delivered care, both in person and telemedicine based exposure therapy
recipients will be included. There will be no randomization; all participants will receive
the peer support 'workout buddy' for exposure therapy assignments.
Veterans (participants and peers) with PTSD will be recruited from the Charleston VA Medical
Center catchment area. Participants will have been assigned to exposure therapy for PTSD and
either started treatment, or dropped out before treatment; peers will have successfully
completed exposure therapy for PTSD. Those eligible to participate will also include Veterans
who are identified as "at-risk" of dropping out, Veterans who are uncomfortable completing in
vivo exposure activities, and those who may have PTSD symptoms, but at the sub-threshold
level. Participants will receive 8-12 weekly sessions of exposure therapy treatment with
assistance of a PE Peer. Half of subjects will be randomized to the PE+Workout Buddy
condition, where they will complete treatment with the assistance of a Veteran who will meet
them at least once per week for in vivo exposure therapy assignments, for 3-4 weeks at the
beginning of treatment. Half of subjects will be randomized to the PE+General Support
condition, where they will complete treatment with the assistance of a Veteran who will call
them via telephone once per week to encourage session attendance and ask about treatment
progress, life stresses, etc. General support peers will also meeting Veterans 2-4 times per
month to check in about treatment progress. All participants and peers will be consented.
Participants will be assessed at baseline, post-treatment, and 3- & 6-month follow-up.
Center catchment area. Participants will have been assigned to exposure therapy for PTSD and
either started treatment, or dropped out before treatment; peers will have successfully
completed exposure therapy for PTSD. Those eligible to participate will also include Veterans
who are identified as "at-risk" of dropping out, Veterans who are uncomfortable completing in
vivo exposure activities, and those who may have PTSD symptoms, but at the sub-threshold
level. Participants will receive 8-12 weekly sessions of exposure therapy treatment with
assistance of a PE Peer. Half of subjects will be randomized to the PE+Workout Buddy
condition, where they will complete treatment with the assistance of a Veteran who will meet
them at least once per week for in vivo exposure therapy assignments, for 3-4 weeks at the
beginning of treatment. Half of subjects will be randomized to the PE+General Support
condition, where they will complete treatment with the assistance of a Veteran who will call
them via telephone once per week to encourage session attendance and ask about treatment
progress, life stresses, etc. General support peers will also meeting Veterans 2-4 times per
month to check in about treatment progress. All participants and peers will be consented.
Participants will be assessed at baseline, post-treatment, and 3- & 6-month follow-up.
Participant Inclusion Criteria:
1. Adult male or female over the age of 18 that has served, or is currently serving in
the military.
2. Either diagnosis of PTSD as determined by a Clinician Administered PTSD Scale for
DSM-5 (CAPS-5) clinical interview or CAPS-5 severity ≥ 25, and a PCL-5 score of ≥25.
3. Attempted PE treatment in the past, but did not complete treatment (defined as
dropping out from treatment or refusal to engage in in vivo exposure assignments) OR
identified as "at-risk" of dropping out of current exposure therapy treatment (defined
as failure to complete 3 sessions of therapy within any 6 week period or verbally
indicating that they are not comfortable with the exposure activities).
Participant Exclusion Criteria:
1. Active psychosis or dementia at screening.
2. Suicidal ideation with clear intent.
3. Concurrent enrollment in another clinical trial for PTSD or depression.
Peer Inclusion Criteria:
1. Adult male or female over the age of 18 that has served, or is currently serving, in
the military.
2. Successful competition of exposure therapy treatment in the past and willingness to
act as peer in the program.
3. PCL-5 score of 32 or lower.
Peer Exclusion Criteria:
1. Active psychosis or dementia at screening.
2. Suicidal ideation with clear intent.
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