Testing adaptations of cognitive-behavioral conjoint therapy for
                        PTSD: A randomized controlled pilot study with veterans.

Davis, Louanne W.; Luedtke, Brandi; Monson, Candice M.; Siegel, Alysia; Daggy, Joanne; Yang, Ziyi; Brustuen, Beth; Ertl, Michelle

doi:10.1037/cfp0000148

Cited by 6 publications

(5 citation statements)

References 41 publications

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“…Finally, the dropout rate in the current study was high, although it is similar to previous studies of individual trauma‐focused treatment when dropout is defined in a similar way (Wierwille et al., 2016). Future research should continue to focus on strategies to enhance treatment retention, such as massed treatment delivered in a retreat format (Davis et al., 2021; Fredman et al., 2020) or abbreviated formats (Fredman et al., 2020; Morland et al., 2019), as couples who completed treatment experienced larger gains than those who dropped out. Future research can also expand upon using session‐level data to explore concurrent change in veterans’ and partners’ perceptions of veterans’ PTSD and both partners’ depression symptoms and relationship satisfaction while participating in CBCT for PTSD.…”

Section: Discussionmentioning

confidence: 99%

“…(2020), increases in general relationship adjustment or satisfaction for one or both partners were also seen across studies, as were improvements in patient comorbid symptoms and partner mental health (i.e., depression, anxiety, anger). Improvements in PTSD symptoms and relationship functioning and decreases in partner accommodation have also been observed for several adaptations of CBCT for PTSD, including an abbreviated version delivered in multicouple groups over a single weekend (Fredman et al., 2020, 2021), a present‐focused version (Pukay‐Martin et al., 2015), and a mindfulness‐based version delivered in multicouple groups in a retreat format (Davis et al., 2021).…”

mentioning

confidence: 94%

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Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic

Pukay‐Martin

Fredman

Martin

et al. 2021

Journal of Traumatic Stress

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Cognitive behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) is a 15-session conjoint treatment for PTSD designed to improve PTSD symptoms and enhance intimate relationship functioning. Numerous studies of CBCT for PTSD document improvements in patient PTSD and comorbid symptoms, partner mental health, and relationship adjustment. However, little is known about its effectiveness in real-world clinical settings. Using an intentionto-treat sample of couples who participated in CBCT for PTSD in an outpatient U.S. Veterans Affairs (VA) PTSD clinic (N = 113), trajectories of session-bysession reports of veterans' PTSD symptoms and both partners' relationship happiness were examined. Across sessions, there were significant reductions in veteran-rated PTSD symptoms, d = −0.69, and significant increases in veteran-and partner-rated relationship happiness, ds = 0.36 and 0.35, respectively. Partner ratings of veterans' PTSD symptoms increased before significantly decreasing, d = −0.24. Secondary outcomes of veteran and partner relationship satisfaction, ds = 0.30 and 0.42, respectively; veteran and partner depressive symptoms, ds = −0.75 and −0.29, respectively; and partner accommodation of PTSD symptoms, d = −0.44, also significantly improved from pre-to posttreatment. The findings suggest that CBCT for PTSD was effective for decreasing PTSD and comorbid symptoms in veterans, as well as for improving relationship This article has been contributed to by US Government employees and their work is in the public domain in the USA.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 94%

Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic

Pukay‐Martin

Fredman

Martin

et al. 2021

Journal of Traumatic Stress

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“…A study examining the military‐to‐civilian transition of Australian Defense Force Veterans found that social connectedness was associated with better quality of life and reduced psychological distress (Flack & Kite, 2021). On a relational level, programs may prepare couples and families for changes that may occur in their life structure and relationship dynamic during the transition process (Davis et al, 2021). While the majority of participants stated that their command was supportive and understanding, some military leaders may need increased awareness of the stressors and support needed during the transition process.…”

Section: Discussionmentioning

confidence: 99%

A qualitative study of military service members undergoing medical separation

Lee‐Tauler,

LaCroix,

Huppert

et al. 2024

J Clin Psychol

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ObjectiveLittle research explores military perspectives on medical disability‐related transition. A qualitative study sought to understand transition experiences of United States military Service members found unfit for duty following medical and physical evaluation boards (MEBs and PEBs).MethodsConfidential telephone interviews were conducted with 25 current and prior Service members. Participants were asked to share their experiences before, during, and after the MEB and PEB processes. Interview questions explored (1) health conditions that prompted the medical disability evaluation, (2) reactions to being recommended for separation, (3) transition‐related stress and challenges, and (4) coping strategies. Salient themes were identified across chronological narratives.ResultsParticipants expressed that debilitating physical (e.g., injury) and/or mental (e.g., post‐traumatic stress disorder) illnesses prompted their medical evaluation. In response to the unfit for duty notice, some participants reported emotional distress (e.g., anxiety, anger) connected to uncertainty about the future. Other participants reported relief connected to a sense of progression toward their medical disability claim status. Transition stress included the length of the MEB/PEB process, impact of the COVID‐19 pandemic on the process, financial stress, impact on family life, and compounded effect of these stressors on emotional distress, including depression and suicidal thoughts. Participants reported using adaptive (e.g., psychotherapy) and maladaptive (e.g., excessive drinking) strategies to cope with stress.ConclusionPreliminary reports of emotional distress and transition stress following unfit for duty notices highlight the need for increased support and interventions to facilitate adaptive coping strategies during this vulnerable period.

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“…For instance, several case studies have illustrated CBCT's diverse implementation with respect to relationship type (e.g., Blount et al, 2017) and nature of trauma exposure (e.g., Brown-Bowers et al, 2012). Recent studies specifically investigating adaptations of CBCT have also been promising, including a present-focused version of CBCT for PTSD that is geared toward individuals who are reluctant to participate in trauma-focused therapy (Pukay-Martin et al, 2017); an abbreviated, intensive, multicouple group version of CBCT for PTSD (Fredman et al, 2020(Fredman et al, , 2021; and versions of CBCT that have integrated components of behavioral couples therapy for alcohol use disorder (O'Farrell & Fals-Stewart, 2006;Schumm et al, 2015) and mindfulness (Davis et al, 2021;Luedtke et al, 2015). Taken together, research supports the adaptability of CBCT and suggests it is an effective and scalable treatment.…”

Section: Cognitive-behavioral Conjoint Therapymentioning

confidence: 99%

Considerations in adapting cognitive-behavioral conjoint therapy for posttraumatic stress disorder to a family setting.

Lenton-Brym¹,

Landy²,

Whitfield³

et al. 2024

Journal of Psychotherapy Integration

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Cognitive-behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) is a manualized therapy for couples designed to simultaneously decrease PTSD symptoms and improve relationship functioning. CBCT has only been tested in couples, not families of three or more members. Family therapy for PTSD may have merit given that there is a bidirectional relationship between PTSD symptoms and poor family adjustment. Adapting CBCT for families has the potential to broaden the impact of CBCT on multiple family members. We review the current evidence for CBCT, the familial impact of PTSD, and presently available family-focused treatments for PTSD. Next, we provide an overview of considerations for adapting CBCT to a family context, as informed by an initial effort to administer this intervention to a family of three. Considerations include lengthening the number and duration of sessions to accommodate hearing from more family members, replacing couple-specific content, tweaking instructions for worksheets, and ensuring that all members are included in the in-session and out-of-session practice. Logistical considerations when seeking to deliver family therapy during COVID-19 or virtual treatment are also described. Future research is needed to determine the efficacy of CBCT for treating PTSD within families. Public Health Significance StatementThis paper describes an initial effort to adapt an evidence-based intervention for PTSD (CBCT), designed for use with couples, for use with families of three or more individuals. It concludes that CBCT may be readily adapted to the family context, and it provides key considerations and recommendations for this approach.

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Testing adaptations of cognitive-behavioral conjoint therapy for PTSD: A randomized controlled pilot study with veterans.

Cited by 6 publications

References 41 publications

Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic

Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic

A qualitative study of military service members undergoing medical separation

Considerations in adapting cognitive-behavioral conjoint therapy for posttraumatic stress disorder to a family setting.

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