Cognitive processing therapy for post-traumatic stress disorder in a University Counselling Center: an outcome study

Abstract

More than half of college students endorse experiencing at least one traumatic event. Consistent with other populations, the rate of post-traumatic stress disorder (PTSD) for college students has been reported at around 12%. Despite this, empirically supported treatments for PTSD have not been widely disseminated in University Counselling Centers (UCCs). This study examines outcomes using cognitive processing therapy (CPT) with a sample of n = 26 college students in a UCC setting. This study also examines therapist experience, length of degree and symptom severity on outcome. After completing training, n = 8 therapists completed CPT consultation and certification. Students who participated in individual CPT during this process were administered the PCL-5 and PHQ-9 at weekly sessions. A retrospective chart review was completed. PCL-5 and PHQ-9 scores were separately examined as outcome variables using linear mixed models where session, therapist experience, length of therapist degree, and severity of symptoms were included as fixed effects, and subjects were assumed to have a random effect. Significant reductions in PCL-5 and PHQ-9 scores were observed across treatment. In this sample, 84.6% of students were treatment responders. Results were unchanged when adjusting for therapist level of experience or training. CPT shows strong potential for UCC settings. CPT can be successfully implemented with novice therapists.

Implementing cognitive processing therapy for posttraumatic stress disorder in a university counseling center.

“…In our experience, many students saw great improvement in their PTSD symptoms prior to reaching Session 12 (Wilkinson, von Linden, et al, 2017). This is consistent with the variablelength treatment findings obtained by Galovski and colleagues (2012).…”

“…Clinicians in our setting were required to complete a 3-day CPT workshop with a CPT trainer and then complete two clinical cases during weekly consultation calls over a 6-month period to obtain CPT provider status. Clinical outcomes using mean PCL-5 pre- and posttreatment scores were calculated from these training cases and resulted in a large effect size ( d = 1.152; Wilkinson, von Linden, Wacha-Montes, Bryan, & O’Leary, 2017).…”

“…Sexual assault that occurred during or before college, and childhood sexual and physical abuse, were the most frequent trauma etiologies treated by clinicians in our setting (Wilkinson, von Linden, et al, 2017). Other traumas included serious motor vehicle accidents, witnessing an unexpected death or finding the body of a loved one, and physical assault.…”

Delivery of written exposure therapy for PTSD in a university counseling center.

“…Notably, very few studies have been conducted to evaluate outcomes of empirically supported PTSD treatments in university counseling centers. In one pilot study of CPT, college students ( N = 26) experienced significant reductions in both PTSD and depressive symptoms; however, the corresponding influence of symptom reduction on academic outcomes was not reported (Wilkinson, Von Linden, et al, 2017). While there is evidence suggesting students who complete treatment in a university counseling center have significantly higher GPAs than those who do not complete treatment (Schwitzer et al, 2018), no studies have been published that address the effect of PTSD treatments on corresponding academic outcomes.…”

Engaging stakeholders for change: A learning community methodology for implementing evidence-based, trauma-focused care on college campuses.

“…In a small implementation and outcome study of CPT in one UCC, researchers found that CPT could be adapted to the UCC setting (Wilkinson-Truong et al, 2019), was effective in reducing PTSD symptoms for students (Wilkinson et al, 2017), and was related to less burnout among clinicians (Wilkinson et al, 2017). However, very few UCC therapists endorse using PE or CPT (Wilkinson et al, 2017). In another study of UCC mental health professionals’ approach to treating trauma found that the majority perceived “supportive counseling” to be the most effective and 24% to 35% of the professionals did not use CPT or PE and/or did not know if they were effective (Artime & Buchholz, 2016), the authors found that only 44% of the UCCs represented in this study provided specialized training for treating PTSD and only slightly more than half (54%) provided training in treating sexual assault.…”