This trial is being completed to develop a stepped-care talk therapy model for patients with PTSD. Specifically, this study is testing whether beginning with one type of therapy is better than beginning with another type of therapy, and whether moving to a different therapy after four sessions is more helpful than staying with the same therapy, depending on how well it is working.
The central hypothesis is that beginning with a low- or medium-intensity PTSD intervention and then titrating intensity based on early indications of response will result in clinically significant PTSD symptom reduction with parsimony of resources.
Receive care at a participating federally qualified health center (FQHC)
Have a Posttraumatic Stress Disorder checklist (PCL-5) score greater or equal (≥) to 33
Own a mobile device that can be used for the PTSD Coach App
Have had psychotropic medication stability for at least 4 weeks
Severe cognitive impairment that in the judgment of the investigators makes it unlikely that the participant 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)
High risk of suicide (defined as meeting criteria for Action Step 3 on the Participant Suicide Risk Screening form
Severe alcohol or substance use disorder (moderate-severe alcohol use disorder on Alcohol Use Disorders Identification Test (AUDIT) (scores ≥ 15) or high risk on National Institute on Drug Abuse Quick Screen (scores ≥ 27))
Active psychosis or unmanaged bipolar disorder
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Treatment groupsSee each treatment group below.
University of Michigan
Lead sponsor
National Institute of Mental Health (NIMH)
Collaborator