Combining Group-Based Exposure Therapy With Prolonged Exposure to Treat U.S. Vietnam Veterans With PTSD: A Case Study

Authors

  • David J. Ready,

    Corresponding author
    1. Emory University Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
    • Department of Veterans Affairs Medical Center-Atlanta, Decatur, Georgia, USA
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  • Edward M. Vega,

    1. Department of Veterans Affairs Medical Center-Atlanta, Decatur, Georgia, USA
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  • Virginia Worley,

    1. Department of Veterans Affairs Medical Center-Atlanta, Decatur, Georgia, USA
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  • Bekh Bradley

    1. Department of Veterans Affairs Medical Center-Atlanta, Decatur, Georgia, USA
    2. Emory University Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
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  • This researchwas supported by the Atlanta VA Medical Center's Mental Health Service Line and Research Service Line. Those identified researchers herein are employees of the Department of Veterans Affairs. The views expressed in this article do not necessarily represent the views of that Department or of the United States.

Correspondence concerning this article should be addressed to David J. Ready, Mental Health Service Line (116A), VA Medical Center - Atlanta, 1670 Clairmont Road, Decatur, GA 30033. E-mail: David.Ready@va.gov

Abstract

Group-based exposure therapy (GBET) of 16-week duration was developed to treat combat-related posttraumatic stress disorder (PTSD) and decreased PTSD symptoms in 3 noncontrolled open trials with low attrition (0%–5%). Group-based exposure therapy has not produced as much PTSD symptom reduction as Prolonged Exposure (PE) within a U.S. Veterans Affairs PTSD treatment program, although PE had more dropouts (20%). This pilot study was of a model that combined key elements of GBET with components of PE in an effort to increase the effectiveness of a group-based treatment while reducing its length and maintaining low attrition. Twice per week, 8 Vietnam combat veterans with PTSD were treated for 12 weeks, with an intervention that included 2 within-group war trauma presentations per participant, 6 PE style individual imaginal exposure (IE) sessions per participant, daily listening to recorded IE sessions, and daily in vivo exposure exercises. All completed treatment and showed Significant reductions on all measures of PTSD with large effect sizes; 7 participants no longer met PTSD criteria on treating clinician administered interviews and a self-report measure at posttreatment. Significant reductions in depression with large effect sizes and moderate reductions in PTSD-related cognitions were also found. Most gains were maintained 6 months posttreatment.

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