Does case formulation improve outcomes in Cognitive Processing Therapy for PTSD? A randomized controlled trial.

Cognitive Processing Therapy (CPT) is an evidence-based therapy for PTSD. Although clinicians often use these therapies flexibly and protocol deviations occur, the effects of such deviations are largely unknown. This randomized trial (N =93) examined the effect of using case formulation (CF) to guide protocol deviations that incorporated evidence-based techniques to address challenges to optimal treatment outcomes, with standard CPT the comparator treatment. Assessments occurred at pretreatment, posttreatment and 6-month follow-up (Clinician-Administered PTSD Scale, MINI, PTSD Checklist, Depression Anxiety Stress Scale). Both groups demonstrated large reductions in PTSD and depression (d’s 2.50-3.66 and 1.19-1.79, respectively).