Absence of conflict of interest.
Citation
Monson, C. M., Macdonald, A., Vorstenbosch, V., Schnaider, P., Goldstein, E. S. R., Ferrier-Auerbach, A. G., & Mocciola, K. E. (2012). Changes in social adjustment with cognitive processing effects of treatment and association with PTSD symptoms. Journal of Traumatic Stress, 25, 519-526.
Highlights
- The study’s objective was to examine the impact of cognitive processing therapy on earnings.
- The study is a randomized controlled trial that collected self-reported data directly from veterans.
- There were no statistically significant relationships between cognitive processing therapy and earnings.
- The quality of causal evidence presented in this report is low because the authors did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to cognitive processing therapy; other factors are likely to have contributed.
Intervention Examined
Cognitive Processing Therapy
Features of the Intervention
Cognitive processing therapy is a six-week cognitive program with 12 sessions. During these sessions and through assigned homework activities, participants reflect and write about their traumatic events, read and add to their accounts of the events, and engage in discussions with others. Participants are encouraged to experience emotions they might have suppressed because of traumatic events; identify connections between events, thoughts, and feelings; and counter problematic beliefs.
The program was delivered by six clinicians with doctoral degrees who have experience using cognitive processing therapy and with treating post-traumatic stress disorder (PTSD).
Features of the Study
The study is a randomized controlled trial and included 46 people who were recruited from the U.S. Department of Veterans Affairs and who had presented conditions of PTSD because of a military-related event. The authors collected self-reported survey data from the participants and used a statistical model to compare the earnings outcomes of members of the treatment and control groups.
Study Sites
The study took place in the United States, with study participants recruited from the U.S. Department of Veterans Affairs medical center in Washington, DC.
Findings
Earnings
- The study found no statistically significant relationships between cognitive processing therapy and earnings.
Considerations for Interpreting the Findings
The authors did not establish that the intervention and comparison groups were similar before the intervention. Specifically, the authors did not account for differences in terms of race, gender, and age between the groups. In addition, the authors did not assess whether the groups’ earnings were similar more than one year before the intervention. These existing differences between the groups—and not cognitive processing therapy—could explain the observed differences in outcomes.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to cognitive processing therapy; other factors are likely to have contributed.
Additional Sources
Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74(5), 898-907.