Deep Brain Reorienting for Posttraumatic Stress Disorder

Stream 1: Military members and Veterans receiving the DBR Intervention:

Inclusion criteria

• 18 to 65 years old
• Current or former military member / Veteran (for Stream 1 only)
• DSM-5 PTSD diagnosis determined via the CAPS-5
• If on psychiatric medications: stable ≥ 4 weeks
• Fluent in English
• Ability to provide informed consent and participate in therapy sessions
• Able to benefit from short-term therapy, as determined by study assessment

Exclusion criteria

• High-risk clinical state (e.g., suicidal or homicidal intent; substance withdrawal) requiring acute intervention.
• History of moderate to severe head or brain injury leading to impaired functioning (e.g., a Glasgow Coma Scale Score < 15 at the time of incident assessed retrospectively by participant; sustained loss of consciousness leading to impaired functioning)
• Cognitive impairment limiting informed consent
• Significant untreated medical illness
• History of neurological disorder, pervasive developmental disorder, bipolar or psychotic disorder
• Alcohol/substance use problems within the last 3 months requiring medical withdrawal or likely to interfere with therapy.
• Degree of mental distress that is unlikely to benefit from a short-term therapy (for our participant's well-being, it will be necessary that we believe it possible to safely address the issues/triggers brought up in treatment within the 8 sessions).
• Any condition that, in the clinical opinion of study psychiatrists or clinicians, would make psychotherapy ineffective or unsafe, or that would interfere with study engagement and completion (e.g., homeless, ongoing psychosocial crisis, etc).

Other considerations:

Participants will be asked not to start any new PTSD treatments (medications or psychotherapy) 4 weeks prior to study enrollment and until study participation is complete.

If already taking psychiatric medications, doses must be stable for at least 4 weeks prior to enrolling in the study, and remain stable until study completion.

Participants in DBR stream must be able and willing to pause other trauma-focused psychotherapies (e.g., CPT, EMDR, exposure therapy) while receiving DBR in the study. Non-trauma focused therapies (e.g. CBT) or supportive talk with a therapist may continue.

Stream 2: Civilian and other TAPs receiving the DBR Intervention:

Inclusion criteria

• ≥ 18 years old
• Trauma-related disorder, moral injury, another post-traumatic mental health condition (e.g., Post traumatic stress injury (PTSI)), or a mental health condition arising as a consequence of a trauma or extreme stress.
• If on psychiatric medications: stable ≥ 4 weeks
• Fluent in English
• Ability to provide informed consent and participate in therapy sessions

Exclusion criteria

• Active psychosis or mania.
• High-risk suicidal intent requiring acute intervention
• Substance use disorder requiring medical withdrawal, or likely interfering with therapy engagement
• Cognitive impairment limiting informed consent
• Current participation in trauma-focused psychotherapy
• Currently involved in litigation
• The participant's condition is unlikely to benefit from short-term therapy. For our participant's well-being, it will be necessary that we believe it possible to safely address the issues/triggers brought up in treatment within the 8 sessions. It is likely that some potential participants will not be ready for trauma therapy.
• Any condition that, in the clinical opinion of study psychiatrists or clinicians would make psychotherapy ineffective or unsafe, or that would interfere with study engagement and completion (e.g., homelessness, ongoing psychosocial crisis, etc).
• Participants will be asked to refrain from starting any new treatment for PTSD until study participation is complete and pause other trauma-focused therapy.

Stream 3: Clinicians Receiving the DBR Training and Clinical Consultation:

Inclusion criteria

• Mental Health Clinicians licensed to provide psychotherapy interventions in Canada
• Fluent in English
• Willing to provide informed consent for the study procedures
• Confidence and experience treating trauma and dissociation, including previous training in trauma-focused psychotherapies.