Pearson CR, Kaysen D, Huh D, Bedard-Gilligan. (2019). Randomized controlled trial of culturally adapted cognitive processing therapy for PTSD substance misuse and HIV sexual risk behavior for Native American women. AIDS and Behavior. doi: 10.1007/s10461-018-02382-8
Researchers evaluated a cultural adaptation of Cognitive Processing Therapy (CPT) for Native American women with post-traumatic stress disorder (PTSD) and substance misuse in a randomized controlled trial. Researchers recruited 73 sexually active Native American women with PTSD symptoms and substance misuse (2+ episodes of heavy drinking in the past year or any illicit substance use in the past 3 months) using advertisements posted at tribal service centers, colleges, churches, fairs, and powwows in the Pacific Northwest. Participants were randomly assigned to receive CPT or to a waitlist control group that received CPT after 6 weeks. The adapted 13-session CPT intervention improved readability, made content more relevant to trauma experienced by Native Americans, and incorporated aspects of Native American culture. Participants completed assessments of PTSD symptoms, alcohol use and related problems, substance use, and high-risk sexual behavior at baseline, 6 weeks follow-up (immediate post-intervention/waitlist), and 3 months post-intervention. Waitlist participants completed an additional assessment 6 weeks after CPT was made available. Immediate CPT participants experienced significantly larger reductions in PTSD symptoms severity, frequency of alcohol use, and sexual risk behaviors between baseline and 6 weeks follow-up compared to control. Waitlist participants experienced a significant improvement in PTSD symptoms between CPT initiation and the post-intervention assessment. Most participants (82%) attended at least one session of CPT and those who who attended at least one session proceeded to complete more sessions (6.1 sessions, on average). Researchers found that greater intervention session completion was related to greater reductions in PTSD symptoms and alcohol related problems.