A randomized controlled trial testing theory‐driven enhancements to increase the efficacy of and engagement in a brief cognitive‐behavioural therapy text‐message intervention for co‐occurring posttraumatic stress disorder symptoms and alcohol misuse

Abstract

AbstractObjectiveEngaging individuals with co‐occurring posttraumatic stress disorder (PTSD) and alcohol misuse (AM) in effective treatments is difficult. Brief, self‐directed approaches that deliver empirically supported intervention techniques, such as cognitive‐behavioural therapy (CBT) strategies, via technology may be effective and easier‐to‐access alternatives to traditional in‐person therapy approaches for PTSD + AM. This paper describes the protocol for an intervention development study (NCT05372042) that evaluates a text‐message intervention combining CBT texts with techniques from cognitive psychology (message framing) and social psychology (growth mindsets) for treatment of PTSD + AM.MethodThe study uses a 3 (message framing: gain vs. loss vs. no framing) × 2 (mindset: growth mindsets vs. not) factorial design to test enhancements to CBT texts. Individuals age 18+, who report symptoms of PTSD and AM, will be recruited to participate. Participants will complete screening, verification, and baseline measures. They will be randomized to condition and receive 3 text messages per week for 4 weeks. Participants will be assessed at post‐, 1‐, and 3‐month follow‐up.ResultsAnalyses will evaluate whether framing and growth mindsets enhance the efficacy of CBT texts. A priori decision rules will be applied to select the intervention condition that is both the most effective and the simplest, which will be tested in a follow‐up randomized controlled trial.ConclusionsThis study will identify the simplest, most efficacious CBT intervention for PTSD + AM. Its use of cognitive and social psychology‐based enhancement and of a factorial decision can serve as examples of how to enhance and increase engagement in brief, self‐directed CBT interventions.