# Enhancing Memory in Cognitive Processing Therapy for Older Adults with PTSD

> **NIH VA I21** · PHILADELPHIA VA MEDICAL CENTER · 2024 · —

## Abstract

Posttraumatic stress disorder (PTSD) is prevalent among veterans and is a substantial public health burden.
Several psychotherapies, including cognitive processing therapy (CPT), have a strong evidence base for their
efficacy in PTSD. However, many individuals show limited benefit from such treatments, particularly older
Veterans. One factor likely affecting treatment response is poor encoding, storage, and retrieval of the skills
and treatment points that are learned in psychotherapy. Individuals with PTSD display deficits in learning and
memory, and aging is independently associated with declines in memory and executive functioning. Thus,
older adults with PTSD may be at heightened risk of cognitive dysfunction that could impact their ability to
benefit from frontline PTSD treatments. To this end, pre-treatment memory functioning has been shown to
consistently predict treatment response in psychotherapy for PTSD. Inefficient learning and memory for
psychotherapy content may be one mechanism explaining this relationship, as poor learning of therapy content
is linked with worse treatment adherence and outcomes. The primary aim of this proposal is to examine the
feasibility and acceptability of integrating a novel Memory Support intervention into the provision of CPT for
older adults with PTSD. The Memory Support intervention was developed such that specific strategies to
enhance encoding and retrieval of therapy content and skills can be integrated into manualized psychotherapy.
However, no prior studies have integrated this intervention into treatments for PTSD. The proposed project will
be guided by a user-centered design framework for treatment development and be conducted in three phases.
In the first phase, we will develop a modified CPT treatment manual that systematically integrates Memory
Support, with clinician (n=3) and Veteran (n=3) feedback to provide guidance on process and techniques. In
the next phase, we will conduct iterative refinement of the modified treatment through a case series in older
Veterans (n=3) with an experienced CPT therapist. Finally, we will conduct a small feasibility randomized
controlled trial (n=20) in which we will examine accrual, retention, completion, acceptability, and variability in
symptom and functional outcomes, as well as all procedures for a larger trial. The proposed project offers
substantial conceptual innovations by bridging foundational work from rehabilitation neuropsychology and
psychotherapy mechanisms research and will provide valuable pilot data to inform a novel intervention for
older Veterans with PTSD that can be tested in future large-scale studies. Such approaches may be especially
relevant for Veterans with neurocognitive deficits (e.g., memory), potentially suggesting a target for a
personalized approach to mental health care.

## Key facts

- **NIH application ID:** 10800955
- **Project number:** 1I21RX004627-01A1
- **Recipient organization:** PHILADELPHIA VA MEDICAL CENTER
- **Principal Investigator:** James Cobb Scott
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10800955

## Citation

> US National Institutes of Health, RePORTER application 10800955, Enhancing Memory in Cognitive Processing Therapy for Older Adults with PTSD (1I21RX004627-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10800955. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*