Recruiting

PE, CPT, WET

Sponsor:

The University of Texas Health Science Center at San Antonio

Code:

NCT06953687

Conditions

Post Traumatic Stress Disorder PTSD

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Prolonged Exposure Therapy

Cognitive Processing Therapy

Written Exposure Therapy

Shared Decision Making (SHARE)

Study Details

Brief summary:

The purpose of this research study is to learn about how Shared Decision Making, when used to decide treatment, impacts treatment engagement, retention, and outcomes for active duty military personnel seeking treatment for posttraumatic stress disorder (PTSD).

Shared Decision Making between the service member and the therapists will be used to match patients to 1 of 3 different types of therapy for PTSD: (1) Prolonged Exposure (PE) therapy, (2) Cognitive Processing Therapy (CPT), or (3) Written Exposure Therapy (WET) in 1 of 2 different frequencies: (1) massed (daily) or (2) spaced (weekly).

Conditions

Post Traumatic Stress Disorder PTSD

Study ID

NCT06953687

Start date

May 9, 2025

Status verified date

Aug, 2026

Completion date

Sep, 2028

Anticipated

Primary completion date

Sep, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

1. Adult active duty military service members aged 18 or older.
2. Meets diagnostic criteria for PTSD based on the Clinician Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders-5 (CAPS-5).

Exclusion Criteria:

1. Acute suicidality or homicidality requiring immediate intervention, such as hospitalization.
2. Moderate to severe brain injury as assessed by the History of Head Injury Form
3. Severe alcohol consumption patterns as assessed using the Alcohol Use Disorders Identification Test and warranting immediate intervention as determined by clinical judgement.
4. Experiencing active psychosis or mania as determined by scores on the Prodromal Questionnaire and Mood Disorder Questionnaire in combination with clinical judgement.

Study Design

Enrollment

200 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Supportive Care

Interventions and Outcome Measures

Arms

experimental: Prolonged Exposure (PE) Therapy Massed

Daily treatment sessions Monday-Friday for up to 24 sessions

experimental: Prolonged Exposure (PE) Spaced

Weekly treatment formula for up to 24 sessions

experimental: Cognitive Processing Therapy (CPT) Massed

Daily treatment sessions Monday-Friday for up to 24 sessions

experimental: Cognitive Processing Therapy (CPT) spaced

Weekly treatment formula for up to 24 sessions

experimental: Written Exposure Therapy (WET) Massed

Daily treatment sessions Monday-Friday for up to 24 sessions

experimental: Written Exposure Therapy (WET) Spaced

Weekly treatment formula for up to 24 sessions

Interventions

Prolonged Exposure Therapy

PE is a cognitive-behavioral treatment for PTSD that is typically delivered in ten 90-minute sessions . For the current study using a variable length approach, participants may complete up to 24 sessions. Based on emotional processing theory PE addresses trauma-related avoidance of thoughts, behaviors, and situations, as well as unhelpful beliefs about oneself, others, and the world that were learned as a result of trauma.

Cognitive Processing Therapy

CPT is a 12-session, cognitive behavioral PTSD treatment typically delivered in 60-minute sessions that can be personalized to include fewer or additional sessions. For the current study using a variable length approach, participants may complete up to 24 sessions. CPT is based in cognitive theory and posits that impeded recovery following trauma occurs due to unhelpful and unrealistic beliefs that may develop after trauma, leading to chronic anger, guilt, shame, and avoidance of trauma reminders. During CPT, patients learn about PTSD symptoms, impeded recovery and cognitive theory, and the connection between trauma-based thoughts and feelings.

Written Exposure Therapy

WET is a cognitive behavioral therapy for PTSD that typically consists of 5 weekly 50-minute sessions. For the current study using a variable length approach, participants may complete up to 7 sessions. WET is based on an extinction and emotional processing treatment model. First, patients learn about PTSD and the role of avoidance in maintaining PTSD symptoms. Next, patients are guided to write about their trauma for 30 minutes and afterwards, the therapist briefly checks in with the patient. This procedure is followed for the next 4 sessions, with guidance to first write about the trauma, and in later sessions to write about consequences of the trauma and the patient's current meaning of their lives. The goals of WET are to assist the patient in emotionally processing the event and reduce avoidance of trauma-related thoughts and memories, which facilities recovery.

Shared Decision Making (SHARE)

The study will use the SHARE Approach to facilitate treatment planning and decision-making. SHARE stands for:

1. Seek the patient's participation
2. Help the patient explore and compare treatment options
3. Assess the patient's values and preferences
4. Reach a decision with the patient
5. Evaluate the patient's decision The Shared Decision Making Patient Preference Checklist will be used to determine the participant's preference for type of treatment, frequency of treatment sessions, and treatment delivery modality. Step 5 also includes following up with the patient and making changes if something it not working well for the patient.

Primary outcome measure

  • Completion of treatment initiation [ Time Frame: Baseline to Treatment Session 1 (approximately 2 weeks) ]
  • Completion of all Treatment sessions [ Time Frame: Baseline to Posttreatment (between 2 months and 7 months, depending on treatment selected and speed of progress) ]
  • Preference for type of treatment [ Time Frame: Measured at Pre-Treatment Shared Decision-Making Session ]
  • Posttraumatic Stress Disorder Checklist (PCL-5) [ Time Frame: Baseline to 1 month follow up assessment (between 2 months and 7 months, depending on treatment selected and speed of progress) ]

Central Contacts and Locations

Central contacts

Vanessa Jacoby, PhD

254-289-3468jacobyv@uthscsa.edu

Alan L Peterson, PhD

210-562-6700petersona3@uthscsa.edu

Locations

Carl R. Darnall Army Medical Center (CRDAMC)

Recruiting

Fort Hood, Texas, United States, 76544

Contacts

Marielsy Pimentel, PsyD

254-288-6474

University of Texas Health Science Center at San Antonio

Recruiting

San Antonio, Texas, United States, 78229

Contacts

Vanessa Jacoby, PhD

254-289-3468jacobyv@uthscsa.edu

More Information

Sponsor

The University of Texas Health Science Center at San Antonio

Last update posted

Aug 19, 2026

Last verified

Aug, 2026

Keywords

  • Shared Decision Making
  • Patient Characteristics
  • Patient Treatment preference
  • Treatment engagement
  • Treatment outcomes

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by The University of Texas Health Science Center at San Antonio on 2026-08-19.