Reconsolidation of traumatic memories protocol compared to trauma-focussed cognitive behaviour therapy for post-traumatic stress disorder in UK military veterans: a randomised controlled feasibility trial

Jackie Sturt, Rebecca Rogers, Cherie Armour, David Cameron, Lisa de Rijk, Francesca Fiorentino, Trisha Forbes, Callum Glen, Annmarie Grealish, Josh Kreft, Ida Meye de Souza, Eric Spikol, Vasiliki Tzouvara, Neil Greenberg

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Abstract

Background: Posttraumatic stress disorder (PTSD) occurs more commonly in military veterans than the general population. Whilst current therapies are effective, up to half of veterans commencing treatment don’t complete it. Reconsolidation of Traumatic Memories (RTM) protocol is a novel, easy to train, talking therapy with promising US findings. We examine the feasibility of undertaking an efficacy trial of RTM in UK veterans.

Methods: A parallel group, single-centre randomised controlled feasibility trial with a post-completion qualitative interview study. Sixty UK military veterans were randomised 2:1 to RTM (n=35) or Trauma Focussed CBT (n=25). We aimed to determine the rate of recruitment and retention, understand reasons for attrition, determine data quality and size of efficacy signal. We explored veterans’ perceptions of experiences of joining the trial, the research procedures and therapy, and design improvements for future veteran studies. UK military veterans with a diagnosis of PTSD or complex PTSD, and clinically significant symptoms, were recruited between January 2020 and June 2021. Primary outcome was feasibility using pre-determined progression criteria alongside PTSD symptoms, with depression, recovery and rehabilitation as secondary outcomes. Data were collected at baseline, 6, 12 and 20 weeks. Interviews (n=15) were conducted after 20 weeks. Both therapies were delivered by trained charity sector provider therapists.

Results: Participants’ mean age was 53yrs, the mean baseline PTSD symptoms score assessed by PCL-5 was 57. Fifty had complex PTSD and 39 had experienced ≥4 traumas. Data were analysed at 20 weeks for feasibility outcomes (n=60) and mental health outcomes (n=45). Seven of eight progression criteria were met. The RTM group experienced a mean 18-point reduction on the PCL-5. TFCBT group participants experienced a mean reduction of 8 points. 48% of the RTM group no longer met diagnostic criteria for PTSD compared to 16% in the TFCBT group. All veterans reported largely positive experiences of the therapy and research procedures and ways to improve them.

Conclusion: RTM therapy remains a promising psychological intervention for the treatment of PTSD, including complex PTSD, in military veterans. With specific strengthening, the research protocol is fit for purpose in delivering an efficacy trial.

Original languageEnglish
Article number175
JournalPilot and Feasibility Studies
Volume9
DOIs
Publication statusPublished - 13 Oct 2023

Bibliographical note

© 2023. BioMed Central Ltd., part of Springer Nature.

Keywords

  • Posttraumatic stress disorder
  • PTSD
  • Veteran
  • Reconsolidation of Traumatic Memories
  • trauma-focused CBT

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