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Adaptive Decision-making And Personalized Treatment for PTSD (ADAPT-PTSD)

Changing the Treatment Course: Clinical Trial of Sequenced Interventions to Optimize Treatment for Veterans With PTSD

Who can join

Ages 18 and older · All sexes

Inclusion Criteria:

1. Veterans eligible for PE and CPT at the participating PTSD treatment-providing clinic who are
2. At least 18 years or older
3. Score ≥ 31 on the PCL-5 secondary to a Criterion A traumatic event
4. Own a mobile device that can be used for the therapy companion mobile app (Prolonged Exposure (PE) coach or Cognitive Processing Therapy (CPT) coach).

Exclusion Criteria:

1. Acute suicide risk requiring clinical intervention
2. Need for detoxification
3. Unmanaged psychosis or bipolar disorder
4. Severe cognitive impairment that makes it unlikely that participants can adhere to the study regimen (as evidenced by confusion, inability to track discussion or answer questions, or other clear and significant indicators of cognitive impairment)
5. Current or past 12-month engagement in PE or CPT.

About the study

By doing this research project, the investigators hope to learn which strategies work best to help veterans who are not benefiting from their first PTSD treatment or not completing between-session homework assignments regularly that might improve treatment response. The investigators also want to learn how best to match the right type and amount of treatment to each individual veteran. By conducting this research project, they hope to:

* See if trying a different treatment strategy for veterans not responding to their first PTSD treatment would be more helpful * See if sending text message prompts between sessions encourages more completion of between-session homework

What is being tested

• Modular Cognitive Processing Therapy (behavioral)
• Modular Prolonged Exposure Therapy (behavioral)
• Step Down Treatment (behavioral)
• Digital Interventions (behavioral)
• Cognitive Processing Therapy (CPT) (behavioral)
• Prolonged Exposure (PE) (behavioral)

Sponsor: The University of Texas Health Science Center at San Antonio · Participants: 302 · Started: Dec 12, 2025

Contact the study team

• Stefanie LoSavio, PhD · Phone: 210-562-6700
• Rebecca Sripada, PhD · Phone: 734-222-7432

Official record on ClinicalTrials.gov — NCT07176273

Locations in the U.S.

Conditions

• Post-Traumatic Stress Disorder

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.