Multi-site Feasibility of Compassion Meditation for Veterans with PTSD

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PROJECT SUMMARY/ABSTRACT Posttraumatic stress disorder (PTSD) is a common health concern among Veterans. Although empirically-supported approaches are widely available, engagement rates are low and partial/non response is common. There has been considerable interest in the role of complementary and alternative interventions for PTSD, but little research is available to guide decisions about care. Compassion meditation (CM), a contemplative practice that is intended to foster connectedness with others, shows promise for the treatment of PTSD in Veterans. In healthy populations, CM fosters positive emotion and social connectedness, both of which are known to enhance coping and resilience in the face of extreme stress. Based on this theoretical rationale, we recently completed a two-phase proof of concept trial of CM for Veterans with PTSD. The first phase employed qualitative and quantitative procedures to iteratively refine an existing CM protocol, CBCT® (Cognitively-Based Compassion Training), for Veterans with PTSD. The second phase utilized a pilot randomized controlled trial to establish the feasibility and acceptability of a randomized trial of CM for Veterans with PTSD and to examine potential clinical impact. On the basis of promising results, the proposed project will evaluate the feasibility of a future multi-site efficacy trial of CM for PTSD. Although our prior work is an encouraging first step, key questions remain. First, our data come from a single site in Southern California. It is possible that there are regional differences in the acceptability of CM, so we plan to examine the feasibility of recruiting and retaining Veterans residing in another area as well as confirming the acceptability of the approach to a more diverse sample. Second, our previous trial relied on a single therapist, who was actively engaged in the development process. It is important to demonstrate that others can be trained to deliver the approach with fidelity and to have some confidence that our results are attributable to the protocol rather than to an individual. Finally, in the interest of ultimately understanding the way in which these interventions lead to symptom change, we will continue to refine our assessment strategy, including adding behavioral methodologies to augment what can be gleaned from self-report measures. If successful, this project will lay the necessary groundwork for an efficacy trial of CM, which ultimately could provide an additional evidence-based treatment option for Veterans with PTSD.