Effectiveness of massed cognitive processing therapy for posttraumatic stress disorder: A retrospective analysis

Trauma exposure can lead to posttraumatic stress disorder (PTSD), a condition with significant individual and societal costs. Yet, access to evidence-based PTSD treatment, such as cognitive processing therapy (CPT), remains limited. Delivering CPT on an accelerated (i.e., massed) schedule via telehealth could increase access while preserving effectiveness. This study aimed to evaluate changes in PTSD, anxiety, and depressive symptoms over the course of virtual massed CPT delivered by a commercial virtual trauma clinic. The sample included adult patients with clinician‑diagnosed PTSD who completed 3 or more telehealth CPT sessions per week. PTSD, anxiety, and depressive symptoms were assessed at intake, discharge, and 30 and 90 days postdischarge. Paired t tests compared symptoms from intake to discharge; linear mixed‑effects models examined symptom trajectories over time. Analyses included 148 patients. Large effect sizes were observed for improvements in PTSD (ΔM = 39.00), d = 2.94; anxiety (ΔM = 8.90), d = 1.79; and depressive symptoms (ΔM = 8.23), d = 1.49, from intake to discharge. Symptom improvements for PTSD and depression were maintained at 30 and 90 days, whereas anxiety remained significantly improved from baseline at both time points but showed modest rebound between 30 and 90 days. Virtual massed CPT produced rapid, very large, and durable reductions in PTSD, depression, and anxiety. These findings support virtual massed CPT as a feasible option to expand access to evidence‑based PTSD care in community settings.