Therapist Treatment Adherence and Effectivity of a Five Day High-Intensity Inpatient Treatment for Posttraumatic Stress Disorder Language of

Abstract

Background: High intensity trauma therapies (HITT) consisting of daily sessions of trauma-focused therapy (TFT) are a relatively new, but promising development in the field of PTSD research. Current high intensity treatments are variably composed, including different types of trauma therapies and supporting elements (e.g. sports, yoga). Objective: Aim of the current study was to test the efficacy of a high intensity inpatient trauma therapy proscribing EMDR and exposure in reducing PTSD symptom severity. Additionally, the type and amount of deviation within the program were explored using an analysis of therapist treatment adherence. Lastly, the study aimed to examine the impact of different types of therapies provided where deviance occurred within the high intensity format on treatment effectivity. Methods: Treatment effectivity was analyzed by comparing scores on the PTSD Checklist for the DSM-5 (PCL-5) pre-and post-treatment as well as at follow-up using a paired samples t-test and a repeated measures ANOVA. Therapist treatment adherence was tested by categorizing data obtained from studying therapy notes of 107 patients (1070 sessions) into 11 different treatment categories and calculating the percentage of adherence and percentage of occurrence for each therapy observed. Analysis of the effect of treatment type on treatment effectivity could not be conducted because of insufficient spread in the data. Results: HITT led to a significant reduction in PTSD symptom severity both directly following treatment and at follow-up. Analysis of therapist treatment adherence showed an adherence of 78.4%. The most commonly occurring type of deviation was other types of trauma-focused treatment, with over 90% of total sessions including TFT. Conclusion: The present study demonstrated that high intensity inpatient treatments are effective in reducing PTSD symptom severity. Further study into the optimal composition of such treatments is needed.