Determining What is Right for Whom: A Hybrid Experimental Clinical Trial of Tailored Intervention Sequencing to Maximize Effectiveness of PTSD Treatment

Therapist, soldier and man talking, support and counseling for military trauma, mental health and memory of war. Speaking, therapy and young veteran or army person with psychologist helping on sofa.
Therapist, soldier and man talking, support and counseling for military trauma, mental health and memory of war. Speaking, therapy and young veteran or army person with psychologist helping on sofa.

Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) are the most effective treatments for PTSD; however, up to 41% of patients do not improve significantly. It remains unclear how best to adapt treatment when patients show early non-response or struggle with between-session homework. To address this, our team developed the Hybrid Experimental Design (HED), a novel approach that integrates therapist-delivered and digital strategies. HED allows us to identify optimal treatment sequences for each patient. In our study (N=302), participants are randomized to CPT or PE. After 6 sessions, early responders or non-responders are further randomized to adapted treatment or maintenance strategies. Additionally, daily digital prompts are used to support homework completion. This research aims to develop more effective, efficient, and individualized PTSD treatment.