Cognitive behavioral treatment for acute posttrauma distress: A randomized, controlled proof-of-concept study among hospitalized adults with burns

Model System:

Burn

Reference Type:

Journal article

Accession No.:

J82936

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2020 , 101, 1, Supplement 1, S16-S25

Publication Website:

Abstract:

Study evaluated the feasibility of conducting a randomized controlled trial (RCT) of the Safety, Meaning, Activation and Resilience Training (SMART) intervention versus nondirective supportive psychotherapy (NDSP) in an acutely hospitalized adult survivor of burn injury sample. The study also assessed the preliminary effect of SMART on acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) symptom reduction as secondary prevention. SMART is a manualized, 4-session cognitive behavioral therapy-based psychological intervention targeting ASD, PTSD, and MDD symptoms. NDSP is a manualized, 4-session protocol. Fifty acutely injured, hospitalized adult survivors of burn injury were randomly assigned to SMART or NDSP. Due to dropout and missing data, the final sample size was 40, with 21 SMART and 19 NDSP participants. The Davidson Trauma Scale (DTS) assessed the frequency and severity of ASD and PTSD symptoms, and the Patient Health Questionnaire-9 (PHQ-9) measured MDD symptoms. Assessments were conducted at pretreatment, immediately posttreatment, and 1 month posttreatment. At baseline, median DTS scores and PHQ-9 scores were above clinical cutoffs and did not differ across groups. At 1 week and 1 month posttreatment, median DTS and PHQ-9 scores were beneath clinical cutoffs in the SMART group; scores remained above clinical cutoffs in the NDSP group at these time points. Results indicate that it is feasible to conduct an RCT of SMART in hospitalized adult survivors of burn injury. SMART has the potential to yield clinically significant outcomes. Additional studies are needed to replicate and extend these findings.

Author(s):