Effectiveness in routine care: trauma-focused treatment for PTSD
Objective: The efficacy of trauma-focused cognitive behaviour therapy (tf-CBT) has been well established in randomized controlled trials (RCTs). More research is needed to demonstrate the effectiveness of tf-CBT in routine clinical care settings.Method: Eighty-five patients (68 female) with a primar...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | European Journal of Psychotraumatology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20008066.2025.2452680 |
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| author | Antje Krüger-Gottschalk Sascha T. Kuck Anne Dyer Georg W. Alpers Andre Pittig Nexhmedin Morina Thomas Ehring |
| author_facet | Antje Krüger-Gottschalk Sascha T. Kuck Anne Dyer Georg W. Alpers Andre Pittig Nexhmedin Morina Thomas Ehring |
| author_sort | Antje Krüger-Gottschalk |
| collection | DOAJ |
| description | Objective: The efficacy of trauma-focused cognitive behaviour therapy (tf-CBT) has been well established in randomized controlled trials (RCTs). More research is needed to demonstrate the effectiveness of tf-CBT in routine clinical care settings.Method: Eighty-five patients (68 female) with a primary diagnosis of PTSD received tf-CBT at two German outpatient centres (Münster and Mannheim) between 2014 and 2016. Treatment was delivered mainly by therapists in training and treatment duration was based on symptom course. The treatment consisted of a preparation phase, a trauma-focused phase (comprising imaginal exposure, discrimination training, changing dysfunctional appraisals) and a phase of reclaiming-your-life assignments, and relapse prevention. In an intent-to-treat-analysis (ITT), linear mixed effects models were fitted for self-assessments of traumatic symptom severity using the PTSD Checklist for DSM-5 (PCL-5) and the Clinician-Administered PTSD Scale for DSM–5 (CAPS-5). Potential moderators for treatment outcome, e.g. number of suicide attempts, were investigated.Results: The observed treatment effect was large for both the CAPS-5 (ITT: Cohen’s d = 2.07, CI [1.62, 2.51]; completers d = 2.34, CI [1.84, 2.83]) and PCL-5 respectively (ITT: d = 2.02, CI [1.56, 2.48]; completers d = 2.15, CI [1.66, 2.64]), and remained stable six months and one-year post-treatment. N = 27 patients (31.48%) were defined as study dropout and of these, n = 12 (14.12%) dropped out of the study but completed treatment. None of the fixed-effect estimates for treatment predictors interacted significantly with the effect of time.Conclusions: Tf-CBT is well-tolerated and it can be effectively delivered in routine clinical care. Its large treatment effects underline the practicability and benefits of the approach. This trial demonstrates its broad applicability among individuals with diverse patterns of clinical characteristics and comorbidities. |
| format | Article |
| id | doaj-art-ebeefdd569a342039f93ff75c77b6a6f |
| institution | DOAJ |
| issn | 2000-8066 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj-art-ebeefdd569a342039f93ff75c77b6a6f2025-08-20T03:22:16ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2452680Effectiveness in routine care: trauma-focused treatment for PTSDAntje Krüger-Gottschalk0Sascha T. Kuck1Anne Dyer2Georg W. Alpers3Andre Pittig4Nexhmedin Morina5Thomas Ehring6Institute of Psychology, University of Münster, Münster, GermanyInstitute of Psychology, University of Münster, Münster, GermanyZISG Mannheim, Mannheim, GermanyDepartment of Psychology, School of Social Sciences, University of Mannheim, Mannheim, GermanyInstitute of Psychology, University of Göttingen, Göttingen, GermanyInstitute of Psychology, University of Münster, Münster, GermanyDepartment of Psychology, LMU Munich, Munich, GermanyObjective: The efficacy of trauma-focused cognitive behaviour therapy (tf-CBT) has been well established in randomized controlled trials (RCTs). More research is needed to demonstrate the effectiveness of tf-CBT in routine clinical care settings.Method: Eighty-five patients (68 female) with a primary diagnosis of PTSD received tf-CBT at two German outpatient centres (Münster and Mannheim) between 2014 and 2016. Treatment was delivered mainly by therapists in training and treatment duration was based on symptom course. The treatment consisted of a preparation phase, a trauma-focused phase (comprising imaginal exposure, discrimination training, changing dysfunctional appraisals) and a phase of reclaiming-your-life assignments, and relapse prevention. In an intent-to-treat-analysis (ITT), linear mixed effects models were fitted for self-assessments of traumatic symptom severity using the PTSD Checklist for DSM-5 (PCL-5) and the Clinician-Administered PTSD Scale for DSM–5 (CAPS-5). Potential moderators for treatment outcome, e.g. number of suicide attempts, were investigated.Results: The observed treatment effect was large for both the CAPS-5 (ITT: Cohen’s d = 2.07, CI [1.62, 2.51]; completers d = 2.34, CI [1.84, 2.83]) and PCL-5 respectively (ITT: d = 2.02, CI [1.56, 2.48]; completers d = 2.15, CI [1.66, 2.64]), and remained stable six months and one-year post-treatment. N = 27 patients (31.48%) were defined as study dropout and of these, n = 12 (14.12%) dropped out of the study but completed treatment. None of the fixed-effect estimates for treatment predictors interacted significantly with the effect of time.Conclusions: Tf-CBT is well-tolerated and it can be effectively delivered in routine clinical care. Its large treatment effects underline the practicability and benefits of the approach. This trial demonstrates its broad applicability among individuals with diverse patterns of clinical characteristics and comorbidities.https://www.tandfonline.com/doi/10.1080/20008066.2025.2452680Trauma-focused treatmentPTSDtreatment effectivenessclinical routineoutcome predictorsTratamiento centrado en el trauma |
| spellingShingle | Antje Krüger-Gottschalk Sascha T. Kuck Anne Dyer Georg W. Alpers Andre Pittig Nexhmedin Morina Thomas Ehring Effectiveness in routine care: trauma-focused treatment for PTSD European Journal of Psychotraumatology Trauma-focused treatment PTSD treatment effectiveness clinical routine outcome predictors Tratamiento centrado en el trauma |
| title | Effectiveness in routine care: trauma-focused treatment for PTSD |
| title_full | Effectiveness in routine care: trauma-focused treatment for PTSD |
| title_fullStr | Effectiveness in routine care: trauma-focused treatment for PTSD |
| title_full_unstemmed | Effectiveness in routine care: trauma-focused treatment for PTSD |
| title_short | Effectiveness in routine care: trauma-focused treatment for PTSD |
| title_sort | effectiveness in routine care trauma focused treatment for ptsd |
| topic | Trauma-focused treatment PTSD treatment effectiveness clinical routine outcome predictors Tratamiento centrado en el trauma |
| url | https://www.tandfonline.com/doi/10.1080/20008066.2025.2452680 |
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