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Research In progress; Recruiting

Comparing Two Ways to Treat People with

PTSD and Substance Use Disorder -- The
COMPASS Study
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Project Summary
This research project is in progress. PCORI will post the research findings on this page within 90
days after the results are final.

PCORI has identified Post-Traumatic Stress Disorder (PTSD) as an important research topic.
Patients, caregivers, clinicians, and others want to learn: Which treatments for adults with
PTSD are most effective, and for whom? To help answer this question, PCORI launched an
initiative in 2019 on Treatment of Post-Traumatic Stress Disorder (PTSD) in Adults
<https://www.pcori.org/funding-opportunities/announcement/treatment-posttraumatic-stress-disorder-adults-
cycle-1-2019>. The initiative funded this research project and others.

What is the research about?

Posttraumatic stress disorder, or PTSD, is a mental health problem in which people relive
trauma over and over. People with PTSD may have bad dreams or scary thoughts. Many
people with PTSD also have substance use disorder, or SUD. SUD involves long-term use of
alcohol or other drugs. Two types of treatments that can help people with PTSD are trauma-
focused psychotherapy, or TFT, and non-trauma-focused psychotherapy, or NTFT. Doctors
don’t know how well treatments that help patients with PTSD work for patients with both
PTSD and SUD.

In this study, the research team is comparing how well TFT and NTFT work to reduce PTSD
symptoms in patients with PTSD and SUD. The team is also looking to see which treatment
patients are more likely to complete.

Who can this research help?

Results may help patients with PTSD and SUD and their doctors when considering ways to
treat PTSD.
What is the research team doing?
The research team is recruiting 420 patients with PTSD and SUD from 14 Veterans Affairs
medical centers. The team is assigning patients by chance to receive either TFT or NTFT. All
patients receive weekly treatment with a therapist for three months. Patients also receive
SUD treatment as part of their usual care.

In the TFT group, patients receive one of two treatments. In the first treatment, patients
receive 90-minute sessions that help them face their fear by thinking about their own past
trauma. In the second treatment, patients receive 60-minute sessions that help them change
upsetting thoughts about trauma. Patients receive the treatment their therapist usually
provides.

In the NTFT group, patients receive 60-minute sessions that focus on helping them to better
understand and solve problems in their current life.

Doctors are asking patients about their PTSD symptoms before, right after, and three and six
months after treatment. The research team is comparing how well TFT and NTFT improve
patients’

PTSD symptoms
Treatment completion
Drug or alcohol use
Ability to perform activities of daily living
Anger
Sleep
Quality of life
Depression
Treatment satisfaction

The research team wants to know if these outcomes vary among different groups of
patients. These groups include patients who use different types of drugs or those who have
different treatment preferences.

Patients with lived experience with PTSD and SUD and doctors who treat patients with PTSD
and SUD are helping to plan and conduct this study. Healthcare system administrators and
researchers who are experts in PTSD and SUD are advising on the study.

Research methods at a glance

Design Element Description

Design Randomized controlled trial

 Design Element Description

420 adults with both PTSD and SUD seeking SUD treatment
Population
at 1 of 14 Veterans Affairs clinical sites

TFT: Prolonged exposure therapy or cognitive processing

Interventions/ therapy
Comparators
NTFT: Present-centered therapy

Primary: PTSD symptom severity; PTSD treatment

noncompletion

Secondary: substance use; PTSD-related psychosocial

Outcomes
functioning; PTSD diagnosis and remission; problems
caused by substance use; anger; sleep disturbances; quality
of life; depression; treatment satisfaction

Timeframe 6-month follow-up for primary outcomes

Project Information
Principal Investigator
: Shannon M. Kehle-Forbes, PhD
Organization
: Center for Veterans Research and Education
Project Budget: $6,285,378
Project Title
: Comparative Effectiveness of Trauma-Focused and Non-Trauma-Focused
Treatment Strategies for PTSD among Those with Co-Occurring SUD (COMPASS)

Key Dates
Board Approval Date
: November 2019
Project End Date
: November 2024
Year Awarded
: 2019
Study Registration Information
NCT Number: NCT04581434 <https://clinicaltrials.gov/ct2/show/nct04581434>

Tags
Project Status In progress; Recruiting

Award Type Research

Health Conditions
Mental/Behavioral Health Addiction/Substance Abuse

Post Traumatic Stress Disorder

Populations
Women Individuals with Multiple Chronic/co-morbid Conditions

Veterans

Funding Opportunity Treatment of Posttraumatic Stress Disorder (PTSD) in Adults

Type

Intervention Strategy
Behavioral Interventions Drug Interventions

Other Clinical Interventions Shared Decision Making

Telemedicine Technology Interventions

Training and Education Interventions

Research Priority Area Assessment of Prevention, Diagnosis, and Treatment Options

State
Minnesota
Last updated: March 4, 2022

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Washington, DC 20036
Phone: (202) 827-7700 |
Fax: (202) 355-9558
info@pcori.org

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