Cognitive Processing Therapy for PTSD: What client characteristics promote successful outcome and long-term wellbeing?

Reg Nixon, Marja Elizabeth

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review


A number of effective evidence-based treatments exist for PTSD, including Cognitive Processing Therapy (CPT), a trauma-focussed cognitive-behavioural intervention. As seen across a range of treatments, not everyone responds following CPT. The purpose of this presentation is to report on some of the characteristics associated with good treatment response. This will improve our understanding of the individual differences that influence outcome, and critically, identify the variables that perhaps can be leveraged early in therapy to maximize an optimal treatment response. Clients (N = 93) were randomised to either standard CPT or CPT with case formulation (CPT+CF). CPT+CF allowed therapists to deviate from the protocol for up to 5 sessions to address issues interfering with PTSD treatment (e.g., comorbidity).Assessments were conducted at pretreatment, posttreatment, and 6-month follow-up. Diagnostic interviews included the Clinician Administered PTSD Scale (CAPS) and Mini-International Neuropsychiatric Interview (MINI). A number of standard self-report measures were used (e.g., the PTSD Checklist, PCL-5; Depression, Anxiety and Stress Scale, DASS-21). Of relevance to the current presentation we indexed clients’ perceived social support at the beginning of treatment (single item), as well as coping ability and quality of relationships (AQoL), and hope of treatment success (via treatment credibility ratings). All clients have completed treatment, with some follow-ups to be completed. Overall we found in the current data strong treatment effects on PTSD and depression that were comparable between the two treatments. Lack of social support and poor relationship quality moderated depression outcomes over time, irrespective of treatment condition (lower levels associated with higher depression). Low levels of coping was associated with poorer PTSD and depression outcomes. Clients who dropped out of treatment showed lower levels of social support, relationship quality and coping, and higher PTSD and depression symptoms at pretreatment. Regression indicated that lower social support and coping at pretreatment accounted for dropout even after time since trauma, initial symptom severity, and treatment credibility was controlled. Full findings will be presented in July, however preliminary analyses indicate that life context and perceived ability to cope might be important variables to consider in treatment planning. Itis important to note our initial analyses suggest that even in the presence of low social support and other challenges, many clients still responded very well to treatment. How best to identify characteristics of clients that enables accurate treatment matching to optimise clinical outcomes requires ongoing study.
Original languageEnglish
Title of host publicationProceedings of the 9th World Congress of Behavioural & Cognitive Therapies, Berlin, July 17th–20th 2019
Subtitle of host publicationVolume 1 Research Applied Issues
EditorsThomas Heidenreich, Philip Tata
Number of pages1
ISBN (Print)9783871598517
Publication statusPublished - 2019
Event9th World Congress of Behavioral and Cognitive Therapies. - Berlin, Berlin, Germany
Duration: 17 Jul 201920 Jul 2019


Conference9th World Congress of Behavioral and Cognitive Therapies.


  • Cognitive Processing Therapy
  • CPT
  • PTSD
  • Wellbeing
  • treatments


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