Effectiveness and tolerability of massed prolonged exposure therapy for PTSD in a CAF Veteran: A case report

Posttraumatic stress disorder (PTSD) is associated with significant distress, impairment, and societal cost. Prolonged exposure therapy (PE) is a gold standard psychotherapy that has been validated for military/Veteran populations, has practical and clinical barriers, and has a moderate drop-out rate, in spite of its efficacy. Standard PE (SPE) involves 12-15 weekly sessions, while massed PE (MPE) involves daily sessions, typically offered over a two-week period. This case report examined the effectiveness and tolerability of MPE in a treatment-seeking Veteran. Baseline structured clinical interview and self-report questionnaire data were compared with post-treatment and follow-up data, with the primary outcome measure being the change in PTSD symptom severity on a structured clinical interview. MPE resulted in reduced PTSD and associated symptom severity as measured at the end of treatment and at follow-up. MPE was described as tolerable, despite short-term discomfort associated with the intense format, and beneficial in facilitating efficient and effective clinical change. This case report demonstrated the effectiveness and tolerability of MPE in a treatment-seeking Veteran. It raises attention for clinical innovation in evidence-based practice and encouragement for empirical replication of this finding in a larger, representative sample.