Trauma-Focused Therapies for PTSD

(HOPE Trial)

This trial tests therapies for PTSD (posttraumatic stress disorder) to determine their effectiveness in helping individuals with opioid and stimulant use disorders engage in substance use treatment after jail release. It compares the effectiveness of starting therapy in jail versus waiting until release to encourage treatment. The trial aims to improve care for those with PTSD who also struggle with drug use, particularly after incarceration. Suitable participants have been diagnosed with probable PTSD and opioid or stimulant use problems while incarcerated. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance treatment strategies for individuals facing similar challenges.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss your specific situation with the trial coordinators or your healthcare provider.

Research shows that both Cognitive Processing Therapy (CPT) and Written Exposure Therapy (WET) are safe treatments for PTSD.

Studies on CPT indicate it is generally easy for people to continue. One study found that only about 6.9% of participants stopped the therapy early, suggesting most people can complete it. Specifically, 82.6% of those who finished the therapy experienced major improvements in their PTSD symptoms, with none still meeting the criteria for PTSD afterward.

For WET, research shows it is also easy for most people to stick with, as less than 10% of participants dropped out. Studies have shown that WET can greatly reduce PTSD symptoms, even for those with other mental health issues or substance use problems.

Researchers are excited about these trauma-focused therapies for PTSD because they offer a tailored approach for individuals in jail, which is not typically part of standard care. The intervention arm allows participants to begin Cognitive Processing Therapy (CPT) or Written Exposure Therapy (WET) while still in jail, providing continuity of care even if they're released early or return to jail. This immediate and consistent access to therapy aims to address PTSD symptoms more promptly and effectively than the usual practice, which typically involves waiting until release to begin treatment. By starting therapy in a controlled environment and maintaining it through transitions, these methods could significantly improve outcomes for people with PTSD, especially those also dealing with opioid or substance use disorders.

This trial will compare Cognitive Processing Therapy (CPT) and Written Exposure Therapy (WET) for PTSD. Studies have shown that both therapies can greatly reduce PTSD symptoms. Research indicates that CPT leads to major improvements in PTSD symptoms, anxiety, and depression, with these benefits lasting over time. CPT has proven effective in various settings and for diverse groups, including individuals with serious mental health issues. WET also significantly reduces PTSD symptoms and matches the effectiveness of more intensive treatments. Both therapies have demonstrated success in clinical trials, confirming their effectiveness in treating PTSD.²³⁴⁶⁷