Structured approach therapy for PTSD in returning veterans and their partners: Pilot findings.

Abstract

Seven married couples, each consisting of a veteran who had been deployed to Operation Iraqi Freedom and a cohabiting female spouse, participated in an uncontrolled trial of structured approach therapy (SAT), a couple-based treatment for posttraumatic stress disorder (PTSD). After completing treatment, the group of 7 returning veterans showed significant reductions in both self- and clinician-related PTSD with posttreatment Hedge g effect size improvements of 2.51 and 3.54, indicating an extremely high magnitude of change in posttraumatic stress. Paired t tests also indicated significant decreases in spousal anxiety, with a trend toward a significant decrease in spousal depression. Analyses of reliable change on the individual level indicated that 4 of 5 veterans and 3 of 4 spouses with dyadic adjustment scores in the distressed range prior to treatment showed reliable decreases in distress over the course of SAT placing them in the nondistressed range at posttreatment. Five of 7 spouses showed reliable decreases in depression, and 4 of 7 spouses showed reliable decreases in anxiety over the course of treatment with SAT. These results support the hypothesis that participation in SAT reduces PTSD in returning veterans while reducing relationship problems and distress in their spouses. More extensive research is being conducted with a larger sample in a randomized clinical trial.

A Daily Diary Study of Posttraumatic Stress Symptoms and Romantic Partner Accommodation

“…Moreover, even if survivors do engage in exposure-based treatment for PTSD, partners who are not aware of the adverse effects of accommodation may be likely to continue to accommodate avoidance to simplify their daily lives, potentially interfering with the full effects of treatment. In recent years, conjoint therapies for PTSD, such as cognitive behavioral conjoint therapy for PTSD (Monson & Fredman, 2012) and structured approach therapy (Sautter, Glynn, Arseneau, Cretu, & Yufik, 2014), have emerged. These therapies do much to intervene in this process by incorporating partners directly into treatment.…”

Couple‐based interventions for PTSD among military veterans: An empirical review

“…Two studies have been published utilizing SAT for PTSD, including one nonrandomized multisubject study (Sautter et al, ), and one RCT (Sautter et al, ). In both studies, self‐rated PTSD symptoms were assessed using the Posttraumatic Stress Disorder Checklist‐Military Version (PCL‐M; Weathers et al, ), and clinician‐rated PTSD symptoms were assessed using the CAPS (Blake et al, ).…”

“…Among the 11 multisubject studies that were included in this review, seven interventions were examined: CBCT for PTSD (Monson et al, ), MB‐CBCT for PTSD (Luedtke et al, ), CTAP (Schumm et al, ), SAT (Sautter et al, ), STRAT (Sautter et al, ), EFCT (Weissman et al, ), and VCIIR (Monk et al, ). These interventions demonstrated reductions in PTSD symptoms and improvements in relationship outcomes (e.g., relationship adjustment or satisfaction) from pre‐ to posttreatment.…”

“…Among the 11 multisubject studies that were included in this review, seven interventions were examined: CBCT for PTSD (Monson et al, 2003), MB-CBCT for PTSD (Luedtke et al, 2015), CTAP (Schumm et al, 2015), SAT (Sautter et al, 2014), STRAT (Sautter et al, 2009), EFCT (Weissman et al, 2018), and VCIIR (Monk et al, 2016).…”

“…Other interventions garnered less research overall but achieved success in reducing PTSD symptoms and improving relationship outcomes. These interventions included MB-CBCT(Luedtke et al, 2015), CTAP(Schumm et al, 2015), SAT(Sautter et al, 2014), STRAT(Sautter et al, 2009), EFCT(Weissman et al, 2018), and VCIIR(Monk et al, 2016). Although the preliminary evidence for these interventions ispromising, future research in several areas would greatly expand our understanding of couple-based interventions for PTSD among SM/Vs.…”