1 - (SYM 15) Enhancing Memory for Therapy Content in PTSD: A Case Series Integrating Memory Support Strategies into Cognitive Processing Therapy

Background: Memory for therapy sessions is often poor, indicating a need to improve the way treatment is delivered to enhance memory and learning of therapy content (Lee & Harvey, 2015). This may be particularly important in PTSD treatment, where low memory functioning is associated with worse treatment outcomes (Haaland et al., 2016). Integrating memory support strategies into therapy (e.g., recall practice, cue-based reminders, etc.) has shown promise for improving outcomes in cognitive therapy for depression (Sarfan et al,. 2023), but this approach has yet to be applied to PTSD. Accordingly, a case series was conducted in which a Memory Support (MS) intervention was integrated into Cognitive Processing Therapy (CPT) for PTSD, with the aim of refining the intervention and assessing initial feasibility and acceptability.

Methods: Four veterans with PTSD received 12 sessions of CPT with MS. Adaptations designed to optimally integrate MS into CPT were iteratively refined during the case series. Outcomes consisted of the frequency of MS strategy use, treatment acceptability, memory for therapy content, and PTSD symptom change.

Results: MS strategy use during CPT (M = 16.6 strategies/session, SD = 4.4) was comparable to prior trials integrating the MS intervention into cognitive therapy for depression. Patient ratings on the Working Alliance Inventory (Range = 46-60 of 60) and Client Satisfaction Questionnaire (Range = 25-32 of 32) indicated strong alliance and satisfaction. Qualitative feedback from patients indicated certain MS strategies (e.g., identifying an end-of-session takeaway) were viewed as particularly helpful for remembering therapy content. Recall of therapy content (i.e., number of treatment points on a free recall task) was variable (M = 5.9, Range = 2-10), as was symptom reduction on the Clinician Administered PTSD Scale (M∆ = 13, Range = 5-22).

Conclusions: Results suggest initial feasibility of integrating MS into CPT and indicate the need for a direct comparison of MS-enhanced CPT to CPT alone. Challenges to optimally integrating MS strategies into CPT (e.g., time management, tailoring strategies to patient needs) will be discussed.