Structured Approach Therapy for PTSD in Returning Veterans and Their Partners: Pilot Findings

Seven married couples, each consisting of a veteran who had been deployed to Operation Iraqi Freedom and a cohabiting female spouse, participated in an uncontrolled trial of structured approach therapy (SAT), a couple-based treatment for posttraumatic stress disorder (PTSD). After completing treatment, the group of 7 returning veterans showed significant reductions in both self-and clinician-related PTSD with posttreatment Hedge g effect size improvements of 2.51 and 3.54, indicating an extremely high magnitude of change in posttraumatic stress. Paired t tests also indicated significant decreases in spousal anxiety, with a trend toward a significant decrease in spousal depression. Analyses of reliable change on the individual level indicated that 4 of 5 veterans and 3 of 4 spouses with dyadic adjustment scores in the distressed range prior to treatment showed reliable decreases in distress over the course of SAT placing them in the nondistressed range at posttreatment. Five of 7 spouses showed reliable decreases in depression, and 4 of 7 spouses showed reliable decreases in anxiety over the course of treatment with SAT. These results support the hypothesis that participation in SAT reduces PTSD in returning veterans while reducing relationship problems and distress in their spouses. More extensive research is being conducted with a larger sample in a randomized clinical trial.