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Effectiveness in routine care: trauma-focused treatment for PTSD.

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Title: Effectiveness in routine care: trauma-focused treatment for PTSD.
Alternate Title: Eficacia en el cuidado rutinario: tratamiento centrado en el trauma para el TEPT.
Authors: Krüger-Gottschalk, Antje (AUTHOR), Kuck, Sascha T. (AUTHOR), Dyer, Anne (AUTHOR), Alpers, Georg W. (AUTHOR), Pittig, Andre (AUTHOR), Morina, Nexhmedin (AUTHOR), Ehring, Thomas (AUTHOR)
Source: European Journal of Psychotraumatology. Dec2025, Vol. 16 Issue 1, p1-12. 12p.
Subjects: Post-traumatic stress disorder, Treatment effectiveness, Clinical medicine, Cognitive therapy, Trauma therapy, Clinical trials
Abstract (English): 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. HIGHLIGHTS: In our phase-IV trial we tested the effectiveness of trauma-focused CBT in routine clinical care. The results demonstrate high effect sizes. No adverse events like suicide attempts were observed. Predictor analysis revealed no significant interaction with the effect of time. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivo: La eficacia de la terapia cognitivo-conductual centrada en el trauma (tf-CBT, por sus siglas en inglés) ha sido bien establecida en ensayos controlados aleatorizados (RCT). Se necesita más investigación para demostrar la efectividad de la tf-CBT en entornos de atención clínica rutinaria. Método: Ochenta y cinco pacientes (68 mujeres) con un diagnóstico primario de TEPT recibieron tf-CBT en dos centros ambulatorios alemanes (Münster y Mannheim) entre el 2014 y el 2016. El tratamiento fue realizado principalmente por terapeutas en formación y la duración del tratamiento se basó en el curso de los síntomas. El tratamiento consistió en una fase de preparación, una fase centrada en el trauma (que incluía exposición imaginada, entrenamiento por discriminación, cambio de evaluaciones disfuncionales) y una fase de tareas de recuperación de la vida y prevención de recaídas. En un análisis por intención-de-tratar (ITT), se ajustaron modelos de efectos mixtos lineales para las autoevaluaciones de la severidad de los síntomas traumáticos utilizando la Lista de Chequeo del DSM-5 para TEPT (PCL-5) y la Escala TEPT Administrada-por-Clinicos (CAPS-5). Se investigaron los posibles moderadores del resultado del tratamiento, por ejemplo, el número de intentos de suicidio. Resultados: Hubo un gran efecto observado del tratamiento tanto para el CAPS-5 (ITT: d de Cohen = 2.07, IC [1.62, 2.51]; pacientes completos d = 2.34, IC [1.84, 2.83]) como para el PCL-5 (ITT: d = 2.02, IC [1.56, 2.48]; pacientes completos d = 2.15, IC [1.66, 2.64]), y se mantuvo estable a los seis meses y un año después del tratamiento. Un total de 27 pacientes (31.48%) fueron definidos como abandonadores del estudio, de los cuales 12 (14.12%) abandonaron el estudio pero completaron el tratamiento. Ninguna de las estimaciones de efectos fijos para los predictores del tratamiento interactuó significativamente con el efecto del tiempo. Conclusiones: La tf-CBT es bien tolerada y puede ser aplicada efectivamente en la atención clínica rutinaria. Sus grandes efectos terapéuticos destacan la viabilidad y los beneficios de este enfoque. Este ensayo demuestra su amplia aplicabilidad entre individuos con diversos patrones de características clínicas y comorbilidades. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effectiveness in routine care: trauma-focused treatment for PTSD.
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  Data: Eficacia en el cuidado rutinario: tratamiento centrado en el trauma para el TEPT.
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  Data: <searchLink fieldCode="AR" term="%22Krüger-Gottschalk%2C+Antje%22">Krüger-Gottschalk, Antje</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kuck%2C+Sascha+T%2E%22">Kuck, Sascha T.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dyer%2C+Anne%22">Dyer, Anne</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Alpers%2C+Georg+W%2E%22">Alpers, Georg W.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pittig%2C+Andre%22">Pittig, Andre</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Morina%2C+Nexhmedin%22">Morina, Nexhmedin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ehring%2C+Thomas%22">Ehring, Thomas</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Psychotraumatology%22">European Journal of Psychotraumatology</searchLink>. Dec2025, Vol. 16 Issue 1, p1-12. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Post-traumatic+stress+disorder%22">Post-traumatic stress disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+medicine%22">Clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+therapy%22">Cognitive therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Trauma+therapy%22">Trauma therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trials%22">Clinical trials</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: 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. HIGHLIGHTS: In our phase-IV trial we tested the effectiveness of trauma-focused CBT in routine clinical care. The results demonstrate high effect sizes. No adverse events like suicide attempts were observed. Predictor analysis revealed no significant interaction with the effect of time. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Objetivo: La eficacia de la terapia cognitivo-conductual centrada en el trauma (tf-CBT, por sus siglas en inglés) ha sido bien establecida en ensayos controlados aleatorizados (RCT). Se necesita más investigación para demostrar la efectividad de la tf-CBT en entornos de atención clínica rutinaria. Método: Ochenta y cinco pacientes (68 mujeres) con un diagnóstico primario de TEPT recibieron tf-CBT en dos centros ambulatorios alemanes (Münster y Mannheim) entre el 2014 y el 2016. El tratamiento fue realizado principalmente por terapeutas en formación y la duración del tratamiento se basó en el curso de los síntomas. El tratamiento consistió en una fase de preparación, una fase centrada en el trauma (que incluía exposición imaginada, entrenamiento por discriminación, cambio de evaluaciones disfuncionales) y una fase de tareas de recuperación de la vida y prevención de recaídas. En un análisis por intención-de-tratar (ITT), se ajustaron modelos de efectos mixtos lineales para las autoevaluaciones de la severidad de los síntomas traumáticos utilizando la Lista de Chequeo del DSM-5 para TEPT (PCL-5) y la Escala TEPT Administrada-por-Clinicos (CAPS-5). Se investigaron los posibles moderadores del resultado del tratamiento, por ejemplo, el número de intentos de suicidio. Resultados: Hubo un gran efecto observado del tratamiento tanto para el CAPS-5 (ITT: d de Cohen = 2.07, IC [1.62, 2.51]; pacientes completos d = 2.34, IC [1.84, 2.83]) como para el PCL-5 (ITT: d = 2.02, IC [1.56, 2.48]; pacientes completos d = 2.15, IC [1.66, 2.64]), y se mantuvo estable a los seis meses y un año después del tratamiento. Un total de 27 pacientes (31.48%) fueron definidos como abandonadores del estudio, de los cuales 12 (14.12%) abandonaron el estudio pero completaron el tratamiento. Ninguna de las estimaciones de efectos fijos para los predictores del tratamiento interactuó significativamente con el efecto del tiempo. Conclusiones: La tf-CBT es bien tolerada y puede ser aplicada efectivamente en la atención clínica rutinaria. Sus grandes efectos terapéuticos destacan la viabilidad y los beneficios de este enfoque. Este ensayo demuestra su amplia aplicabilidad entre individuos con diversos patrones de características clínicas y comorbilidades. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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