Posttraumatic stress disorder and service utilisation outcomes following delivery of Cognitive Processing Therapy in a community mental health setting

Abstract

ABSTRACT Objective The effectiveness of Cognitive Processing Therapy (CPT) for posttraumatic stress disorder (PTSD) in Australian community mental health settings is understudied as is its impact on other mental health service utilisation. Method Adults (N = 155) with PTSD were seen at a large public health service. PTSD severity was measured at pretreatment, during treatment, and at posttreatment. Additional mental health outcomes and therapeutic processes were indexed (e.g., depression and therapeutic alliance) as was mental health service utilisation by participants in the 12-months prior to and 12-months after receiving CPT. Results Significant improvements across all symptom measures and large effect sizes for PTSD outcomes were observed (Cohen’s d = 1.03–1.66). Analysis of the whole sample (intent-to-treat) demonstrated 46.4% of the sample fell below the probable-PTSD cut-off, and 34.1% achieved remission. On average, participants’ use of mental health services (e.g., inpatient hospitalisations and outpatient services) halved in the 12 months following CPT relative to the same period prior to treatment. No significant adverse outcomes were reported. Conclusion CPT is a safe and effective therapy for PTSD which can be delivered in a routine public mental health setting. Further research should be undertaken to formally establish health cost savings from delivering CPT in the Australian health care system.