Peer-led Trauma Therapy for Re-entry

The purpose of the research is to learn more about how to treat PTSD for people directly impacted by incarceration (i.e., have spent time in prison or jail). This research will help identify if a PTSD treatment group that is used in community settings, and led by individuals with lived experience, is helpful in reducing PTSD symptoms among people who have been directly impacted by incarceration.

Participants will complete an interview to determine whether they are experiencing PTSD, and if so, will participate in a 6-week therapy group treatment.

Study Overview

• Status: Completed
• Conditions: PTSD
• Intervention / Treatment: Behavioral: Cognitive Processing Therapy

Detailed Description

Two community Certified Peer Specialists (CPSs) who have experienced incarceration and re-entry from prison, and who have experienced trauma will be trained on delivering group Cognitive Processing Therapy (CPT).

Working with the Wisconsin Department of Health Services (DHS) and community organizations serving formerly incarcerated individuals, researchers will screen individuals for PTSD treatment need, and invite 48 eligible individuals to participate in group CPT co-led by one of the trained CPSs and a trained community therapist or provider.

Eligible participants who are enrolled in the study will be invited to complete a 6-week (12 sessions total) group CPT therapy treatment for PTSD. Participants will also complete pre-, mid-, and post-treatment mental health surveys. Participants will also complete a post-treatment focus group or post-treatment individual interview where they are asked about their experience in the therapy and to provide feedback on the study as a whole.

• Study Type: Interventional
• Enrollment (Actual): 59
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Wisconsin
    • Madison, Wisconsin, United States, 53705
      • University of Wisconsin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 18 years of age or older
• completed a prison or jail sentence
• no current psychosis symptoms
• no active self-harm or active suicidal intent
• able and willing to participate in group therapy
• meet criteria for PTSD treatment need

Exclusion Criteria:

• current and active psychosis
• current and active self-harm and suicidality
• no PTSD diagnosis
• current substance use dependence (not including those used as prescribed for medical reasons) on alcohol, cocaine, amphetamines, inhalants, sedatives or sleeping pills, hallucinogens, or opioids

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cognitive Processing Therapy (CPT); Groups of 6-8 receive CPT to treat PTSD	Behavioral: Cognitive Processing Therapy; CPT is a type of cognitive behavioral therapy recommended for the treatment of PTSD. Delivered over 12 sessions with an emphasis on addressing trauma-related cognitions and challenging trauma-related beliefs. Includes homework assignments. For this study, CPT will be conducted in groups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility: Participation	Will be measured as the percentage of invited, eligible individuals who elect to participate.	Study duration (up to 2 years)
Feasibility: Rate of retention	Will be measured by percentage of participants who complete at least 9 of the 12 study sessions	Study duration (up to 2 years)
Feasibility: Compliance through participation	Will be measured by percentage of participants performing intervention activities during session, such as contributing to the discussion.	Study duration (up to 2 years)
Feasibility: Compliance through homework	Will be measured by percentage of participants completing homework assignments each week.	Study duration (up to 2 years)
Feasibility: Compliance through completing assessments	Will be measured by percentage of participants completing the pre-, mid-, and post-intervention assessment batteries.	Study duration (up to 2 years)
Ratings from 0-5 by clinical supervisors on therapist adherence to five session elements	Higher ratings indicate better adherence to session elements. Assesses for therapist adherence to CPT guidelines as secondary measure of intervention efficacy.	Study duration (up to 2 years)
Ratings 1-7 by clinical supervisors on quality of session elements delivered by therapist	Higher ratings indicate higher-quality session element (scores 1-7; 1=not satisfactory, 4= satisfactory, 7=excellent) by the clinical supervisor. Assesses for therapist compliance as secondary measure of intervention efficacy.	Study duration (up to 2 years)
Change in suicide and self-harm ideation	Beck Depression Inventory-II (BDI-II), item 9. Participants will answer the item on a scale of 0-3, where a score of 2 or 3 indicates higher ideation.	Baseline to end of follow-up (up to 4.5 months)
Participant satisfaction	Using the 8 item Client Satisfaction Questionnaire (CSQ-8), participants will rate their satisfaction with their experience. Scale ranges from 1-4, with total potential scores of 8 to 32 with higher scores indicating greater satisfaction.	One week post-treatment (up to 7 weeks)
Change in PTSD symptom severity	Using the PTSD Checklist for DSM-5 (PCL-5), which is a 20-item self-report measure, symptoms of PTSD will be assessed. Participants will answer items on a scale of 0-4, where 0=Not at all and 4=Extremely. Higher scores indicate higher symptom severity.	Baseline to end of follow-up (up to 4.5 months)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in depression symptom severity	Beck Depression Inventory-II (BDI-II), which is a 21-item self-report measure to assess depression severity. Participants will answer items on a scale of 0-3, where lower scores indicate lower severity.	Baseline to end of follow-up (up to 4.5 months)
Change in trauma related thoughts and beliefs	Posttraumatic Cognitions Inventory (PTCI) is a 33-item measure of negative cognition about the world, negative self-related thoughts, and self-blame. Participants rate each item on a scale of 1-7, 1=totally disagree, 4=neutral, 7=totally agree. Higher scores indicate greater levels of trauma.	Baseline to end of follow-up (up to 4.5 months)
Change in aspects of hopelessness	Beck Hopelessness Scale is a 20-item questionnaire, which participants answer true or false.	Baseline to end of follow-up (up to 4.5 months)
Change in substance use	Tobacco, Alcohol, Prescription Medication, and other Substance Use Tool (TAPS) screens for tobacco use, alcohol use, prescription medication misuse, and illicit substance use in the past year, as well as the past 3 months.	Baseline to end of follow-up (up to 4.5 months)
Change in anxiety symptom severity	Beck Anxiety Inventory (BAI), which is a 21-item self-report measure to assess anxiety severity. Participants will rate how much items bothered them as: Not at all; Mildly but it didn't bother me much; Moderately - it wasn't pleasant at times; or, Severely - it bothered me a lot. More symptoms that caused moderate or severe bother indicate higher severity of anxiety.	Baseline to end of follow-up (up to 4.5 months)

Collaborators and Investigators

• Sponsor: University of Wisconsin, Madison
• Investigators: Principal Investigator: Michael Koenigs, PhD, University of Wisconsin, Madison

Study record dates

Study Major Dates

• Study Start (Actual): November 14, 2023
• Primary Completion (Actual): December 12, 2025
• Study Completion (Actual): December 12, 2025

Study Registration Dates

• First Submitted: August 25, 2023
• First Submitted That Met QC Criteria: August 25, 2023
• First Posted (Actual): August 31, 2023

Study Record Updates

• Last Update Posted (Actual): December 26, 2025
• Last Update Submitted That Met QC Criteria: December 18, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Group therapy; Cognitive Processing Therapy; Previously incarcerated
• Additional Relevant MeSH Terms: Trauma and Stressor Related Disorders; Mental Disorders; Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
• Other Study ID Numbers: 2023-1144; SMPH/PSYCHIATRY/PSYCHIATRY (Other Identifier: UW Madison); Protocol Version 12/02/24 (Other Identifier: UW Madison)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No