Posttraumatic Stress Disorder Clinical Trial
— I-STEPOfficial title:
Implementing a Skills Training Evidence-Based Treatment for Posttraumatic Stress Disorder in Primary Care (I-STEP)
Verified date | February 2024 |
Source | Boston Medical Center |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
A majority of residents in low income communities have been exposed to a potentially traumatic event, and up to half (30-50%) of trauma-exposed residents in safety net clinical settings meet criteria for posttraumatic stress disorder (PTSD). Despite this, only 13% receive treatment. Poor access to PTSD treatment is due to a shortage of mental health specialists. This study aims to evaluate the implementation and effectiveness of a brief, cognitive-behavioral intervention for posttraumatic stress disorder (PTSD)-Skills Training in Affective and Interpersonal Regulation (STAIR)- that will be offered in Boston Medical Center (BMC)'s primary care clinics as the new standard of care following integrated behavioral healthcare (IBH) therapist training. In response to clinician capacity concerns and the impact of the COVID-19 pandemic, we will be offering the intervention in both clinician-administered and self-paced, web-administered formats. The evidence base suggests that STAIR, delivered both synchronously (in-person/telehealth STAIR) and asynchronously (webSTAIR), is associated with significant improvements in PTSD and depression symptoms.
Status | Completed |
Enrollment | 60 |
Est. completion date | February 26, 2024 |
Est. primary completion date | February 26, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Client seen in integrated behavioral health in Boston Medical Center's General Internal Medicine and Family Medicine clinics. - Able to receive therapy in English (per participant report) - Exposure to trauma (as indicated by Life Events Checklist for the DSM-5 [LEC-5]) - Subthreshold or Full Criteria for PTSD (as indicated by the PTSD Checklist for the DSM-5 [PCL-5]) - Reasonable to access to technology needed to support either condition (e.g., phone, computer, internet access). Exclusion Criteria: - Patient is not appropriate for outpatient level of care / standard of care provided in IBH (per clinician judgement) - Currently receiving cognitive behavioral therapy for PTSD elsewhere (e.g., CPT, PE, EMDR). - Patient is experiencing bereavement (death of someone close) as primary clinical concern, and is therefore not a good fit for a PTSD-specific treatment at this time. |
Country | Name | City | State |
---|---|---|---|
United States | Boston Medical Center Clinics | Boston | Massachusetts |
Lead Sponsor | Collaborator |
---|---|
Boston Medical Center | National Institute of Mental Health (NIMH) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Posttraumatic Stress Disorder symptoms measured by PTSD Checklist for DSM-5 (PCL-5) | The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report measure that assesses the 20 DSM-5 symptoms. The PCL-5 scale ranges from Not At All (0) to Extremely (4), where higher scores indicate higher severity of PTSD symptoms. | Change from baseline, 3 months, and 9 months | |
Primary | Feasibility based on retention | The percent of participants who completed at least 90 minutes of an intervention by 3 months | 3 months | |
Primary | Acceptability measured by Client Satisfaction Questionnaire (CSQ-8) at 3 months | The Client Satisfaction Questionnaire (CSQ-8) is an 8-item survey to measure and assess consumer satisfaction with health and human services. Response options differ for each item, the scale ranges from very negative response (1) to a very positive response (4), with higher scores indicating higher satisfaction. | 3 months. | |
Primary | Acceptability measured by Client Satisfaction Questionnaire (CSQ-8) at 9 months | The Client Satisfaction Questionnaire (CSQ-8) is an 8-item survey to measure and assess consumer satisfaction with health and human services. Response options differ for each item, the scale ranges from very negative response (1) to a very positive response (4), with higher scores indicating higher satisfaction. | 9 months. | |
Secondary | General Mental Health Functioning measured by the Brief Symptom Inventory (BSI-18) | The Brief Symptom Inventory (BSI-18) is an 18-item self-report measure to assess psychological problems. The scale ranges from Not At All (0) to Extremely (4), where higher scores indicate higher severity of psychological distress. | Baseline, 3 months, 9 months | |
Secondary | Emotional Regulation measured by the Difficulties in Emotion Regulation Scale (DERS) | The Difficulties in Emotion Regulation Scale (DERS) is a 36-item self-report measure of emotion regulation difficulties. The scale ranges from Almost Never (1) to Almost Always (5), where higher scores indicate higher symptom severity. | Baseline, 3 months, 9 months | |
Secondary | Social Functioning measured by the Interpersonal Support Evaluation List - 12-item version (ISEL-12) | The Interpersonal Support Evaluation List - 12-item version (ISEL-12) is a 12-item self-report measure to assess perceptions of social supports. The scale ranges from Definitely False (1) to Definitely True (4), where higher scores indicate greater social supports. | Baseline, 3 months, 9 months |
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