A multisite randomized controlled effectiveness trial of cognitive processing therapy for military-related posttraumatic stress disorder

Cognitive processing therapy (CPT) is currently applied in military veteran mental health services in many countries. This study tests the effectiveness of community-administered CPT for military-related PTSD under randomized controlled conditions. Fifty-nine treatment-seeking veterans with military-related PTSD were randomly allocated to receive 12 twice-weekly 60 min sessions of CPT or an equivalent period of usual treatment at veterans’ community based counseling services. Intent to treat analyses found significantly greater improvement for participants receiving CPT over usual treatment at post-treatment and 3 month follow-up. CPT also produced greater improvements in anxiety, depression, social and dyadic relationships than usual treatment. No CPT related adverse events occurred during the trial. This trial reports the first randomized controlled trial evidence that CPT is an effective treatment for military PTSD and co-morbid conditions when compared to usual treatment and delivered in community settings by clinicians from diverse disciplines, preferred treatment orientation and levels of experience.

► A randomized controlled trial (RCT) of cognitive processing therapy (CPT) was conducted. ► CPT was more effective for military-related PTSD than treatment as usual (TAU). ► CPT also produced greater improvements in anxiety, depression and relationships than TAU. ► This is the first fully naturalistic RCT of CPT in an existing community service.