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NCT07176273NARecruiting

Adaptive Decision-making And Personalized Treatment for PTSD (ADAPT-PTSD)

The University of Texas Health Science Center at San Antonio

Start Date

12/12/2025

Completion Date

8/14/2028

Summary

By doing this research project, the investigators hope to learn which strategies work best to help veterans who are not benefiting from their first PTSD treatment or not completing between-session homework assignments regularly that might improve treatment response. The investigators also want to learn how best to match the right type and amount of treatment to each individual veteran. By conducting this research project, they hope to: * See if trying a different treatment strategy for veterans not responding to their first PTSD treatment would be more helpful * See if sending text message prompts between sessions encourages more completion of between-session homework

Detailed Description

This study is designed to assist the investigators in answering the clinical question of how to address non-response to first line PTSD treatments. Utilizing an innovative Hybrid Experimental Design (HED), the proposed study involves multiple, sequential randomizations to both therapist-delivered and digital interventions operating on short and long timescales to determine the optimal combination and sequencing of evidence-based interventions to maximize response. This will result in actionable data and, consistent with a personalized medicine approach, an implementable, adaptive treatment regimen that optimizes clinical resource allocation. By recruiting and providing treatment in routine care settings serving veterans with PTSD, the study design maximizes generalizability, relevance to the VA mission, and implementation potential.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: 1. Veterans eligible for PE and CPT at the participating PTSD treatment-providing clinic who are 2. At least 18 years or older 3. Score ≥ 31 on the PCL-5 secondary to a Criterion A traumatic event 4. Own a mobile device that can be used for the therapy companion mobile app (Prolonged Exposure (PE) coach or Cognitive Processing Therapy (CPT) coach). Exclusion Criteria: 1. Acute suicide risk requiring clinical intervention 2. Need for detoxification 3. Unmanaged psychosis or bipolar disorder 4. Severe cognitive impairment that makes it unlikely that participants can adhere to the study regimen (as evidenced by confusion, inability to track discussion or answer questions, or other clear and significant indicators of cognitive impairment) 5. Current or past 12-month engagement in PE or CPT.

Interventions

BEHAVIORAL

Modular Cognitive Processing Therapy

BEHAVIORAL

Modular Prolonged Exposure Therapy

BEHAVIORAL

Step Down Treatment

BEHAVIORAL

Digital Interventions

BEHAVIORAL

Cognitive Processing Therapy (CPT)

BEHAVIORAL

Prolonged Exposure (PE)

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Conditions

Posttraumatic Stress DisorderPTSD

Locations

Augusta VA

Augusta, Georgia 30904

United States

Ann Arbor VA

Ann Arbor, Michigan 48105

United States

Battle Creek VA

Battle Creek, Michigan 49037

United States

Salt Lake City VA

Salt Lake City, Utah 84148

United States