PTSD can develop following a trauma, and the consequences are deeply problematic – from major social, emotional, health and economic costs to individuals and their families, to larger societal costs through affecting productivity and public health budgets.
While effective psychological therapies for PTSD are being used, success rates vary, with between 20-30% of people dropping out of treatment prematurely, and between 40% and 64% still having a PTSD diagnosis by the end of treatment in many studies.
With funding from The Hospital Research Foundation, researchers in the Open Door Initiative at Flinders University have devised a better solution by personalising the therapy techniques in a more flexible program that will best help veterans, first responders and others to address PTSD and other mental health issues.
This change makes a significant difference – because it addresses the specific aspects of PTSD that affect each person and ultimately improves their quality of life.
Personalised therapy the key to success
“We have effective psychological therapies for PTSD, but not everyone responds in the same way. If we can improve existing treatments for another 10-15% of Australians with PTSD, we will improve the lives of 50,000 to 75,000 people a year,” says Professor Reg Nixon, lead investigator and Clinical Research Lead of Open Door Initiative.
“A significant number of Australians will be better off if they receive this modified approach to therapy.
“The combination of personalising our therapy approach and increasing people’s willingness to participate in therapy is a key to the success of the new flexible therapy program.”
The causes of PTSD are varied, from interpersonal and family violence to accidents and combat or war-related events. Veterans and first responders can have high exposure to events that place them at risk of PTSD – and they were the focus of a study led by Professor Nixon to examine a personalised PTSD therapy program, based on Cognitive Processing Therapy (CPT).
Funded by a Prabha Sheshadri Road Home grant from the Hospital Research Foundation, the study recorded a higher than typical level of therapy completion, with 85.7% of participating first responders (police, fire fighters and paramedics) and veterans with PTSD completing treatment.
Participants also noted a significant reduction in PTSD and depression symptoms. Assessment after therapy and again after three-months revealed that all but one participant no longer had PTSD – a success rate of more than 95%.
An important next step is to train more clinicians on how to use flexible PTSD therapy. Professor Nixon and colleague Professor Tara Galovski have published a guide to help clinicians use a well-known therapy like CPT with modifications to improve outcomes for people with PTSD.
“Our early findings show that using flexible CPT with veterans and first responders increases the impact of what is already an effective therapy.”
Findings provide a launching pad for a bigger study
This innovative research has laid the foundations for more work. Although this initial study has shown exciting results, Professor Nixon is mindful of the need for further research. His collaborator, Professor Galovski, has secured a large Rehabilitation Research and Development Service grant from the United States Department of Veterans Affairs, to further study the benefits of personalising CPT for PTSD sufferers. Professor Nixon is a co-investigator on this project.
The large, randomised trial is now underway, recruiting up to 200 veterans in the US, to compare standard CPT against the new flexible approach to therapy (which is called CF-CPT). Therapy for trial participants should be finished by March 2025, with the analysis of results after three-month follow-up assessments starting in June 2025.
“What I find really exciting about this work is that it’s not re-inventing the wheel,” says Professor Nixon. “It’s improving existing therapies, and it’s having a significant impact on people who need our help.”
