Baldwin

This research aims to develop a stepped-care talk therapy model for patients with PTSD, focusing on whether starting with one type of therapy is better than another, and if switching therapies after four sessions based on early response helps more than continuing the same therapy. The study tests the hypothesis that beginning with low- or medium-intensity PTSD interventions and adjusting treatment intensity based on early results will effectively reduce PTSD symptoms while using resources efficiently. Participants receive different behavioral therapies including Prolonged Exposure for Primary Care PE-PC, Full Prolonged Exposure, or a Clinician Supported PTSD Coach App. Treatments begin with four weekly sessions or nine weeks of clinician support, followed by adjustments depending on early response. Early responders may reduce session frequency, while slow responders may switch to more intensive therapy or continue current therapy with altered session schedules. During the study, participants undergo regular clinical assessments including PTSD symptom evaluations using the Clinician-Administered PTSD Scale CAPS-5 and self-reported measures like the PTSD Checklist PCL-5, Patient Health Questionnaire PHQ-9 for depression, and quality of life surveys at baseline and three months. The study monitors symptom changes and treatment adjustments over time, with participation lasting through the treatment and follow-up periods to assess outcomes and resource use.