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Cited by 303Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology Research

Effect of Cognitive-Behavioral Couple Therapy for PTSD: A Randomized Controlled Trial

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Monson, Candice M., Fredman, Steffany J., Macdonald, Alexandra, Pukay-Martin, Nicole D., Resick, Patricia A., Schnurr, Paula P.·2012·JAMA
DOI 10.1001/jama.2012.9307PMC PMC4404628
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Abstract

CONTEXT: Posttraumatic stress disorder (PTSD) is a prevalent condition associated with intimate relationship problems, and intimate relationship factors have been shown to affect individual PTSD treatment outcomes. OBJECTIVE: To compare cognitive-behavioral conjoint therapy for PTSD (a manualized couple therapy delivered to patients with PTSD and their significant others to simultaneously treat PTSD symptoms and enhance relationship satisfaction) with a wait-list condition. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of heterosexual and same-sex couples (n = 40 couples; n = 80 individuals) in which one partner met criteria for PTSD according to the Clinician-Administered PTSD Scale, conducted from 2008 to 2012 in a Department of Veterans Affairs outpatient hospital setting in Boston, Massachusetts, and a university-based research center in Toronto, Ontario, Canada. Symptoms of PTSD, comorbid conditions, and relationship satisfaction were collected by blinded assessors at baseline, at mid treatment (median, 8.00 weeks [range, 1.71-20.43 weeks] after baseline), and at posttreatment (median, 15.86 weeks [range, 7.14-38.57 weeks] after baseline). An uncontrolled 3-month follow-up (median, 38.21 weeks [range, 28.43-50.57 weeks] after baseline) was also completed. INTERVENTION: Couples were randomly assigned to take part in the 15-session cognitive-behavioral conjoint therapy for PTSD protocol immediately (n = 20) or were placed on a wait list for the therapy (n = 20). MAIN OUTCOME MEASURES: Clinician-rated PTSD symptom severity was the primary outcome and was assessed with the Clinician-Administered PTSD Scale. Intimate relationship satisfaction, assessed with the Dyadic Adjustment Scale, patient- and partner-rated PTSD symptoms, and comorbid symptoms were secondary outcomes. RESULTS: PTSD symptom severity (score range, 0-136) was significantly more improved in the couple therapy condition than in the wait-list condition (mean change difference, -23.21; 95% CI, -37.87 to -8.55). Similarly, patients' intimate relationship satisfaction (score range, 0-151) was significantly more improved in couple therapy than in the wait-list condition (mean change difference, 9.43; 95% CI, 0.04-18.83). The time × condition interaction effect in the multilevel model predicting PTSD symptoms (t37.5 = -3.09; P = .004) and patient-reported relationship satisfaction (t68.5 = 2.00; P = .049) revealed superiority of the couple therapy compared with the wait list. Treatment effects were maintained at 3-month follow-up. CONCLUSION: Among couples in which one partner was diagnosed as having PTSD, a disorder-specific couple therapy, compared with a wait list for the therapy, resulted in decreased PTSD symptom severity and patient comorbid symptom severity and increased patient relationship satisfaction. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00669981.

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  • In Monson et al.'s (2012) waitlist controlled trial with a mixed trauma sample, the effects for clinician-rated PTSD from pre- to post-treatment were g = 1.82, and g = .64 for patient-rated and g = .15 for partner-rated relationship adjustment.

    “In that study, the effects for clinician-rated PTSD from pre- to post-treatment were g = 1.82, and g = .64 for patient-rated and g = .15 for partner-rated relationship adjustment.”

    From MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial (2020) · cites this paper as Monson et al., 2012

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  • The effects on PTSD, other symptoms, and relationship outcomes in this study were on par with, or greater than, those previously achieved with CBCT alone.

    “In addition, the effects on PTSD, other symptoms, and relationship outcomes in this study were on par with, or greater than, those previously achieved with CBCT alone.”

    From MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial (2020) · cites this paper as Monson et al., 2012

  • CBCT for PTSD has been tested in community and military/veteran samples in uncontrolled and controlled trials.

    “CBCT for PTSD (Monson & Fredman, 2012) has been tested in community and military/veteran samples in uncontrolled and controlled trials.”

    From MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial (2020) · cites this paper as Monson & Fredman, 2012

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Research works printed but not linked: 3

  1. [16]First MB Spitzer RL Gibbon M Williams JB Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Patient Edition (SCID-I/P) New York Biometrics Research Dept, New York State Psychiatric Institute 2002
  2. [18]Weathers FW Litz BT Herman JA Huska JA Keane TM The PTSD Checklist: reliability, validity and diagnostic utility Proceedings of the 9th Annual Conference of the International Society for Traumatic Stress Studies (ISTSS) San Antonio, TX ISTSS 1993
  3. [26]Hedges LV Olkin I Statistical Methods for Meta-analysis London, England Academic Press 1985

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Authors
Monson, C. M., Fredman, S. J., Macdonald, A., Pukay-Martin, N. D., Resick, P. A., & Schnurr, P. P.
Affiliations
  • Toronto Metropolitan University (CA)
  • Boston University (US)
Corresponding author
Monson, Candice M.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2012-08-15
Volume
308
Issue
7
Pages
700
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2012.9307
PMC
PMC4404628
OpenAlex
W1976692440
Cited by
303
References
27
Citations by year
2026: 5 · 2025: 12 · 2024: 24 · 2023: 18 · 2022: 13 · 2021: 26 · 2020: 26 · 2019: 29 · 2018: 25 · 2017: 25 · 2016: 29 · 2015: 31 · 2014: 17 · 2013: 15 · 2012: 8
FWCI
25.82
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • JAMA
Funders
National Institute of Mental Health (R34MH076813)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
post-traumatic stress disorder, couple therapy, cognitive behavioral therapy, conjoint therapy, relationship satisfaction, PTSD comorbidity, veterans, same-sex couples, PTSD symptom severity, partner involvement in treatment, Dyadic Adjustment Scale, Clinician-Administered PTSD Scale, waitlist control, treatment outcome follow-up
MeSH terms
Adult, Female, Humans, Interpersonal Relations, Male, Middle Aged, Outpatients, Severity of Illness Index, Stress Disorders, Post-Traumatic, Waiting Lists, Cognitive Behavioral Therapy, Treatment Outcome, Couples Therapy

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