Monday, February 12, 2024

SONYA NORMAN, PhD   Dr. Norman directs the U.S. National Center for PTSD’s PTSD Consultation Program, is a researcher in the VA’s Center of Excellence for Stress and Mental Health, and Professor of Psychiatry at the University of California San Diego School of Medicine.

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DOD Grant Number: HT9425-23-1-0861

Project Period: 09/01/2023-05/31/2027

Title: Clinical Effectiveness and Implementation of Trauma-Informed Guilt Reduction Therapy

Compared to Prolonged Exposure (TriGR)

Contracting/Performing Organizations: Veterans Medical Research Foundation of San Diego

         San Diego Veterans Administration Healthcare System

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OVERVIEW

This project proposes to establish whether trauma-informed guilt reduction therapy (TrIGR) is effective for a large group of veterans (anyone who served post 9/11 with guilt from any kind of trauma) and whether it is as effective as longer treatments already available within sessions of TrIGR are noninferior to 12 sessions of prolonged exposure (PE) in reducing posttraumatic stress disorder (PTSD) symptom severity among veterans with PTSD who endorse trauma-related guilt symptoms and superiority in reducing trauma-related guilt and shame, explore treatment differences in change in suicidal ideation and dropout, explore mechanisms of change, and explore if guilt and shame mediate the relationship between treatment condition and PTSD, functioning, and depression outcomes. A hybrid type I randomized treatment clinical trial will be performed. The intervention is administration of TrIGR over 6 weekly sessions and administration of PE over 12 weekly sessions with assessments of primary and secondary outcomes at baseline, 8, 16, and 28 weeks after the first therapy session. The projected results are an understanding of the effectiveness of TrIGR.

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DOD Grant Number: HT94252310669

Project Period: 09/01/2023-05/31/2027

Title: Clinical Effectiveness and Implementation of Massed Prolonged Exposure for PTSD Among

Veterans in Intensive Outpatient Substance Use Treatment (MPE/PTSD)

Contracting/Performing Organizations: Veterans Medical Research Foundation of San Diego

         San Diego Veterans Administration Healthcare System

 

OVERVIEW

This project proposes to evaluate the effectiveness of massed prolonged exposure therapy (M-PE) delivery in substance use disorder (SUD) intensive outpatient programming (IOP) in reducing dropout rates and improving outcomes as compared to weekly PE (WPE) delivery. The specific aims are to (1) compare the effectiveness of M-PE to W-PE concurrent to IOP SUD treatment in impacting posttraumatic stress disorder (PTSD) symptoms and PE completion; (2) compare differences in treatment arms on patient-centered outcomes, including percent days with drug use or heavy drinking, functioning, depressive symptoms, suicidal-related thoughts, and participant satisfaction; (3) conduct a mixed-method process evaluation to understand patients, providers, and clinical -PE, explore barriers and facilitators to integrating M-PE into IOP SUD treatments within Veterans Affairs (VA) and DOD, and identify strategies for widespread implementation. The application outlines a mixed-method 2-group hybrid type I effectiveness/implementation randomized clinical trial. The intervention is that M-PE (delivered 4 days per week over up to 3 weeks) will be compared to PE delivered as usual (i.e., weekly; W-PE) initiated concurrent to IOP SUD treatment programs in 4 VA clinics. The projected results are to learn about barriers and facilitators to implementing M-PE in IOP SUD settings and enable identification of potential implementation strategies for spread in VA and DOD communities as warranted effective PTSD treatments.