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

Forbes, D.; Lloyd, D.; Nixon, R.D.V.; Elliott, P.; Varker, T.; Perry, D.; Bryant, R.A.; Creamer, M.

doi:10.1016/j.janxdis.2012.01.006

Cited by 194Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsSleep and related disorders

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

Forbes, D., Lloyd, D., Nixon, R.D.V., Elliott, P., Varker, T., Perry, D., Bryant, R.A., Creamer, M.·2012·Journal of Anxiety Disorders

DOI 10.1016/j.janxdis.2012.01.006

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Abstract

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.

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Outcome assessors were blinded in only six of the 18 controlled studies (33%).
“outcome assessors were blinded in only six studies (33%; Baker et al. 2006;Forbes et al. 2012;Mills et al. 2012;Forsyth et al. 2017;Shawyer et al. 2017;Kelly et al. 2020).”
From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Forbes et al. 2012
Only three of 18 controlled studies (17%) reported that the sample size was sufficiently large to be confident in the findings with at least 80% power.
“Only three of 18 studies (17%) reported that the sample size was sufficiently large enough to be confident in the findings with at least 80% power (Hugo et al. 2002;Forbes et al. 2012;Meadows et al. 2019).”
From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Forbes et al. 2012
Four of five therapeutic studies examining substance misuse reported significant reductions in participants' consumption of alcohol, tobacco, and other drug use.
“Four of five studies that examined substance misuse reported significant reductions in participants' consumption of alcohol (Forbes et al. 2012), tobacco (Baker et al. 2006;Ashton et al. 2015) and other drug use (Nagel et al. 2009).”
From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Forbes et al. 2012
Participants who engaged in cognitive processing therapy had significant reductions in depressive, anxiety, and post-traumatic stress symptoms.
“Specifically, participants who engaged in cognitive processing therapy had significant reductions in depressive, anxiety and post-traumatic stress symptoms (Forbes et al. 2012).”
From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Forbes et al. 2012

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Authors: Forbes, D., Lloyd, D., Nixon, R. D. V., Elliott, P., Varker, T., Perry, D., Bryant, R. A., & Creamer, M.
Affiliations: The University of Melbourne (AU)
Flinders University (AU)
UNSW Sydney (AU)
Corresponding author: Forbes, D.
ORCID: Forbes, D.
Nixon, R.D.V.
Varker, T.
Bryant, R.A.
Venue: Journal of Anxiety Disorders
Publisher: Elsevier BV
Published: 2012-04
Volume: 26
Issue: 3
Pages: 442-452
ISSN: 0887-6185 (ISSN-L)
DOI: 10.1016/j.janxdis.2012.01.006
OpenAlex: W1983685871
Cited by: 193
References: 47
Citations by year: 2026: 6 · 2025: 4 · 2024: 6 · 2023: 12 · 2022: 18 · 2021: 11 · 2020: 19 · 2019: 16 · 2018: 17 · 2017: 15 · 2016: 18 · 2015: 20 · 2014: 16 · 2013: 14
FWCI: 18.47
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Anxiety Disorders (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
Australian Government
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords: cognitive processing therapy, post-traumatic stress disorder, military veterans, community-based treatment, psychotherapy effectiveness, anxiety, depression, interpersonal relationships, dyads, comorbidities, adverse events
MeSH terms: Adult, Aged, Anxiety, Combat Disorders, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Stress Disorders, Post-Traumatic, Veterans, Cognitive Behavioral Therapy, Treatment Outcome

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

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