# Shared Contributions to Outcomes and Retention in EBPs for PTSD (SCORE PTSD)

> **NIH VA I01** · MINNEAPOLIS VA  MEDICAL CENTER · 2020 · —

## Abstract

Anticipated Impacts on Veterans Healthcare: This research will inform provider- and system-level
interventions to optimize the effectiveness of evidence-based psychotherapies (EBPs) for Posttraumatic
Stress Disorder (PTSD) in routine clinical practice.
Project Background: VHA has committed considerable resources to ensuring that all veterans with PTSD
have access to EBPs. These efforts have focused primarily on two EBPs for PTSD – Cognitive Processing
Therapy (CPT) and Prolonged Exposure (PE). Over the past decade more than 6,300 VHA clinicians have
received VHA competency based training in CPT or PE. Therapists providing CPT and PE are required to use
templated CPT and PE chart notes for session documentation, providing detailed information on the prescribed
elements of CPT and PE delivered in each session. Prior research on CPT and PE has focused primarily on
treatment outcomes, uptake among providers and reasons for drop-out among patients. Understudied are
systematic differences between therapists in their effectiveness, indicators of the quality of CPT and PE
delivery, and the work conditions conducive to positive outcomes. By addressing these evidence-gaps, we will
identify modifiable factors affecting CPT and PE delivery that we can target for intervention and thereby
improve treatment retention and clinical outcomes among Veterans with PTSD.
Project Objectives: Specific aims are to: (a) Examine systematic differences between therapists in CPT and
PE outcomes, and whether certain therapists are more effective with vulnerable patient subgroups, and (b)
Determine whether the therapeutic relationship and therapist adherence predict CPT and PE outcomes and
whether these indicators of therapy quality explain systematic differences between therapists in patient
outcomes. Exploratory aims are to: (a) Determine whether the intensity and consistency of time between
sessions contribute to patient outcomes and at least partially account for systematic differences between
therapists in patient outcomes; (b) Examine whether therapist caseload, clinic setting and resources for
therapy delivery in therapists' work environment contribute to patient outcomes and at least partially account
for systematic differences between therapists in patient outcomes; and (c) Elucidate quantitative findings on
therapist effects, therapy quality and aspects of therapist work context associated with patient outcomes
through qualitative interviews.
Project Methods: This is an explanatory sequential mixed-method study of 200 therapists who deliver CPT or
PE to approximately 2,000 patients with PTSD. Therapists will be enrolled if they use the chart note templates
VHA requires for documentation of CPT and PE and treat at least three patients with CPT or PE over one year.
Patients of these therapists will be included if they have a diagnosis of PTSD and receive at least two sessions
of CPT or PE. After enrollment, therapists will complete a brief online CPT and PE template re...

## Key facts

- **NIH application ID:** 9756159
- **Project number:** 5I01HX002599-02
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** NINA A. SAYER
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-08-01 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9756159

## Citation

> US National Institutes of Health, RePORTER application 9756159, Shared Contributions to Outcomes and Retention in EBPs for PTSD (SCORE PTSD) (5I01HX002599-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9756159. Licensed CC0.

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