Exposure Therapy Administered by Nonspecialty Healthcare Workers Effective in Treating Adolescent PTSD

Prolonged exposure treatment administered by nurses in a community setting is effective in reducing symptom severity in adolescents with posttraumatic stress disorder (PTSD), suggests research data published in the British Journal of Psychiatry.

Researchers randomly assigned 63 adolescents (13-18 years) with PTSD to 7 to 14 weeks of prolonged exposure therapy (n=31) or supportive counseling (n=32). PTSD symptom severity was assessed at baseline, immediately posttreatment, and at 3 and 6 months follow-up using the Child PTSD Symptom Scale. Researchers also captured depression and global functioning at these time points as secondary outcomes. Treatments were administered at schools in Cape Town, South Africa, by nonspecialist nurses who were trained by investigators prior to the trial.

Participants in the prolonged exposure therapy arm experienced greater improvements in PTSD symptom severity from baseline to posttreatment than those receiving supportive counseling (P <.001). Posttreatment, 80% of patients in the exposure therapy group no longer met the diagnostic criteria for PTSD, compared with just 48% of those receiving supportive counseling (P =.017). Exposure therapy was also associated with greater reduction of depressive symptoms (P =.002). At 3 and 6 months follow-up, the exposure therapy group maintained greater improvements in PTSD symptom severity (both P <.001) and depressive symptoms (3 months, P =.024; 6 months, P =.023) compared with those who received supportive counseling. Both treatment modes had similar levels of improvement in global functioning posttreatment and during follow-up.

These data suggest that exposure therapy administered by nonspecialist healthcare workers is an effective intervention for adolescent PTSD. These data could be useful for establishments in South Africa that may not have the resources for more expensive, specialized treatment modes.

Reference

Rossouw J, Yadin E, Alexander D, Seedat S. Prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: task-shifting randomised control trial [published online July 11, 2018]. Br J Psychiatry. doi:10.1192/bjp.2018.130