FIRST PETT : a PTSD Experimental Treatment Trial

Post-Traumatic Stress Disorder (PTSD) is a relatively common condition among ex-Armed Forces personnel. Current trauma-focused psychological therapies are often lengthy and cause distress by repeatedly exposing patients to traumatic memories. FIRST is a four x 90-minute therapy session, remotely-delivered, novel PTSD treatment based on neuro-linguistic programming (NLP). It might better meet the needs of this population because it is time-limited and does not require patients to verbally recount traumatic events. Proof of concept and a strong effect signal for FIRST was established in two earlier small studies with UK military veterans and frontline NHS healthcare workers.

PTSD rates in the general population are 4% but in military veterans it can be up to 17% or higher. For up to 80% of veterans, their PTSD is Complex - associated with multiple, or prolonged, traumas. Charities and policy makers agree that new PTSD therapies are called for that better meet the needs of the Armed Forces Community. We want to find out if FIRST therapy is effective in reducing PTSD symptoms, how it works and whether it can be recommended as a standard NHS treatment option in the future. Our earlier feasibility study with 60 veterans has indicated that FIRST therapy is effective in this way, and we now aim to assess it in a full clinical trial with a larger number of UK military veterans.

We aim to determine the efficacy of FIRST in achieving a minimal clinically important difference in PTSD symptoms. FIRST PETT is an individually computer randomised superiority trial, comparing FIRST to a 24-week waiting list comparator. Over a 19-month period, we will recruit 215 UK military veterans. Eligibility criteria include severity of PTSD symptoms and not currently undertaking other PTSD treatment. FIRST is delivered remotely by trained, supervised therapists through our charity trial partner, Inspire. 

The primary outcome is PTSD symptoms assessed by the PCL-5 at 20-weeks. Secondary outcomes include understanding the impact of FIRST on mental health and wellbeing; maintenance of effect at 52-weeks; and whether the mechanistic pathways can be understood through established cognitive science of PTSD.

FIRST PETT has an active patient and public involvement group of 10 ex-Armed Forces men and women providing valuable insights and feedback on trial design and delivery. Some members participated in the feasibility study and have first-hand experience of receiving therapy.

The study aims to find out if FIRST therapy is effective in reducing PTSD symptoms, how it works and whether it can be recommended as a standard NHS treatment option in the future.

We aim to recruit 215 veterans for this study who are:

UK Armed Forces ex-service personnel, living or working in the UK.

Over 18 years old.

With a diagnosis or PTSD or who are experiencing symptoms of post-traumatic distress.