Shortened Prolonged Exposure Therapy for Chronic Ptsd: a Systematic Case Study and Pilot Randomized Controlled Trial

Posttraumatic stress disorder (PTSD) is a common psychological disorder following trauma and disaster. The estimated prevalence of PTSD is 6-7% in a general population. Due to the frequent occurrence of disasters induced by natural hazards, many Taiwanese people suffer from post-disaster mental health problems. These findings suggest the necessity of promoting evidence-based psychotherapies for PTSD in Taiwan; however, there has been little concern about this necessity over the past decades. To date, several evidence-based psychotherapies for PTSD have been developed in Western societies, some of which may be feasible for treating individuals with PTSD in Taiwan. Of these psychotherapies, prolonged exposure (PE) has the largest number of studies supporting its efficacy and effectiveness. PE been found effective with the widest range of trauma populations and has been studies across cultures (e.g., Netherlands, Israel, and Japan). Given its strong evidence base, we decided to test the efficacy and feasibility of PE for Taiwanese PTSD patients. It is noted that the length of PE session is 90 minutes. This format may be difficult to get reimbursement by insurance, which further prevents mental health professionals to use PE. Recently, some researchers shortened the length of PE session to 60 minutes (with 20-30 minutes of imaginal exposure) and found its efficacy was noninferior to original PE. Based on this, the present study developed a three-year project to investigate the efficacy of shorten PE (i.e., 60 minutes) for local PTSD patients. Specifically, the first-year study used a systematic case study to delineate the effect of PE versus shorted PE with eight PTSD patients. Using a pilot randomized controlled trial design; the second- and third-year study randomly assigned 24 chronic PTSD patients to receive shorted PE or treatment-as-usual (TAU) condition. Our aim will be to examine the efficacy of shorted PE for PTSD, comorbid problems (depression and anxiety symptoms), and posttraumatic growth (PTG) and whether treatment gains will be maintained at 3-, 6-, and 12-month follow-up. Those receiving TAU will receive shorted PE after a 10-week waiting period. Overall, we except that shorted PE will result in substantial improvement in PTSD and depressive symptoms and the increase of PTG in Taiwanese PTSD patients.

Project ID:PF10607-0958
External Project ID:MOST106-2628-H182-001-SS2