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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Main Authors: Antje Krüger-Gottschalk, Sascha T. Kuck, Anne Dyer, Georg W. Alpers, Andre Pittig, Nexhmedin Morina, Thomas Ehring
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
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.
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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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