Randomized Controlled Comparison of Cognitive Behavior Therapy with Rogerian Supportive Therapy in Chronic Post-Traumatic Stress Disorder: A 2-Year Follow-Up

Abstract

Background: To date, there have been no studies comparing cognitive behavior therapy (CBT) with Rogerian therapy in post-traumatic stress disorder. Method: Sixty outpatients with DSM-IV chronic post-traumatic stress disorder were randomized into two groups for 16 weekly individual sessions of CBT or Rogerian supportive therapy (ST) at two centers. No medication was prescribed. Measures included the Post-Traumatic Stress Disorder Checklist Scale (PCLS), the Hamilton Anxiety Scale, Beck Depression Inventory, and Quality of Life. The general criterion of improvement (GCI) was a score of less than 44 on the PCLS. Results: Forty-two patients were evaluated at post-test, 38 at week 52 and 25 at week 104. At post-test, the rate of patients leaving the trial due to worsening or lack of effectiveness was significantly higher in the ST group (p = 0.004). At this point, no between-group difference was found on the GCI and any of the rating scales. Intent-to-treat analysis found no difference for the GCI, but patients in the CBT group showed greater improvement on the PCLS and Hamilton Anxiety Scale. Naturalistic follow-up showed sustained improvement without between-group differences at weeks 52 and 104. Conclusions: CBT retained significantly more patients in treatment than ST, but its effects were equivalent to those of ST in the completers. CBT was better in the dimensional intent-to-treat analysis at post-test.

Long-Term Effects of an Internet-Based Treatment for Posttraumatic Stress

“…We lost 17% from the 3-month follow-up to the 18-month follow-up. Although this is comparable to other longterm follow-ups (Cottraux et al, 2008), it clearly reduces the generalizabilty of the results. Recruitment and retention are regular problems in studies examining the psychopathological long-term response of trauma victims.…”

Cognitive Therapy versus Rogerian Supportive Therapy in Borderline Personality Disorder

“…One may underline the fact that RST by the same teams had long-term effects comparable to those of CBT in the completers of a previous controlled study on PTSD [16]. Rogerian therapists in France are marital counsellors, and not trained in therapy for BPD patients.…”

“…Moreover, they received training and supervision on CT for BPD by Cory F. Newman of Pennsylvania University through three 2-day workshops given in France. The principles and methods of RST were taught in 10 h by role-playing and had been previously used by the same 2 research teams [16]. Before the trial, the 2 centres met for 12 h to harmonise therapeutic techniques and measurement procedures.…”

The Selection and Design of Control Conditions for Randomized Controlled Trials of Psychological Interventions

“…Rigorous clinician training is recommended, but most of the clinical skills and abilities that study clinicians utilize are acquired long before they begin work on a trial. Treating clinicians are usually selected for their training, background, and familiarity with the treatment modality or with the theoretical orientation instantiated in the experimental treatment [10]. Clinicians also tend to arrive with an allegiance to the treatment they are to deliver, or develop one during the trial.…”