Prolonged exposure therapy and supportive counselling for posttraumatic stress disorder in adolescents in a community-based sample, including experiences of stakeholders: study protocol for a comparative randomized controlled trial using task-shifting

Abstract

BackgroundThere is a dearth of empirical evidence on the effectiveness of pharmacological and non-pharmacological treatments for adolescents with posttraumatic stress disorder (PTSD) in developing countries. The primary aim of the study is to examine the effects of prolonged exposure therapy compared with supportive counseling for adolescents with PTSD delivered by nurses trained as counselors.Methods/designA single-blind randomized clinical trial comprising 90 adolescents with PTSD using a permuted block design will be utilized. Nurses previously naïve to prolonged exposure and supportive counselling will be trained to provide these treatments at the adolescents’ high schools. Data collection will last from March 2014 to December 2017 and annually thereafter, dependent on the availability of funding.Participants will receive seven to fourteen 60 min sessions of prolonged exposure treatment (n = 45) or supportive counselling (n = 45). All assessments will be conducted before treatment, at mid-treatment, immediately after treatment completion, at 3-, 6-, and 12-month follow-up, and annually thereafter. It is hypothesized that PE-A will be superior to SC in reducing PTSD symptoms at post-treatment as measured by the CPSS-I administered by an independent evaluator. It is further hypothesized that PE-A treatment gains will be maintained at 3-, 6- and 12-month follow-ups and annually thereafter.DiscussionWhile early indications are that PE-A is an effective treatment for PTSD in adolescents, this study will help determine the effectiveness of PE-A in a South African, community setting (school-based) when task-shifted to nurses, as compared to SC.Trial registrationPan African Clinical Trials Registry: PACTR201511001345372, retrospectively registered 11 November 2015.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1873-x) contains supplementary material, which is available to authorized users.

Therapeutic interventions impact brain function and promote post-traumatic growth in adults living with post-traumatic stress disorder: A systematic review and meta-analysis of functional magnetic resonance imaging studies

“…Prolonged exposure (PE) therapy utilizes a similar cognitive paradigm to CBT but differs insofar that the focus of treatment is on incremental, controlled exposure to a traumatizing stimulus, all with the aim of desensitizing the survivor to threat/fear cues from the stimulus ( Foa, 2011 ). This process of exposure allows individuals to cognitively restructure beliefs about their sense of safety as well as power and control with respect to encountering a traumatizing stimulus in the environment ( Hendriks et al, 2018 ; Rossouw et al, 2018 ). Typically, PE is structured in 12 90-min sessions and conducted in one of two formats: imaginal exposure or in vivo exposure ( Foa and Rothbaum, 1998 ).…”