PTSD treatment with published outcomes

A randomized trial compared CPT delivered in-office, in-home, and by telehealth. Telehealth was the least refused option and produced large PTSD symptom improvements, similar to in-home delivery.

• 120 service members and veterans; 12 sessions of CPT
• Telehealth was least often refused: 17% vs 29% (in-office) vs 54% (in-home)
• Large symptom improvements: telehealth and in-home showed larger gains than in-office; telehealth and in-home were similar

A randomized noninferiority trial found that CPT delivered by videoconference was not worse than in-person CPT for PTSD symptom reduction, with gains maintained at follow-up.

• 125 veterans were randomized to videoconference (n=61) or in-person CPT (n=64).
• 12 sessions were delivered in both conditions.
• PTSD symptom improvements were noninferior via telehealth and were maintained at 3 and 6 months.

A pilot study delivered CPT twice daily for 5 days via telehealth and found high completion, rapid symptom improvement, and durable gains.

• 24 participants enrolled; 95.8% completed the full protocol (10 sessions).
• PTSD symptoms dropped quickly (reported as an average ~5-point PCL-5 reduction per day).
• Improvements were maintained at 3 months, and the study reported no adverse events.

A VA claims-based study found that, after completing CPT or PE, veterans used less psychotherapy and had lower direct mental health costs in the following year.

• Study used national VA databases for 70 veterans who completed CPT or PE.
• There was a significant decrease in individual and group psychotherapy utilization.
• Direct mental health care costs decreased by 39.4% in the year after treatment (with primary care and ED services unchanged).

In a civilian randomized trial comparing PE to sertraline, PE delivered more health benefit per dollar in the base-case economic model.

• 200 adults with chronic PTSD were enrolled across two sites.
• Base-case results favored PE: lower costs (–$262) and higher health benefit (+0.056 QALYs) compared with sertraline.
• In probabilistic analyses, PE was cost-effective in 93.2% of simulations at a $100,000/QALY threshold.

A long-term follow-up of a randomized trial found that CPT (and PE) produced improvements that held steady 5–10 years later.

• Participants were assessed 5–10 years post-treatment (mean 6.15 years).
• Treatment-related symptom decreases were maintained from post-treatment through long-term follow-up.
• At long-term follow-up, 22.2% (CPT) and 17.5% (PE) met PTSD diagnosis.

This 2024 state-of-the-science review summarizes what the field knows about CPT today, what the randomized trials show, and where the evidence is strongest (and still evolving).

• Breadth of evidence: The review notes hundreds of studies over three decades, including multiple randomized controlled trials.
• Beyond PTSD-only outcomes: It summarizes findings on CPT’s effects on common comorbid conditions, plus newer combination approaches.
• How it works: It reviews evidence on cognitive mechanisms of change, the specific targets CPT is designed to shift.