Five-year outcomes in a randomised controlled trial of prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: a task-shifted intervention
In brief
Prolonged exposure cuts teen PTSD scores more than counseling, gains last five years
In a randomized trial of 63 adolescents, both brief prolonged exposure therapy and supportive counseling delivered by non-specialist nurses reduced PTSD symptoms for up to 60 months, but exposure produced greater symptom drops at every follow-up except the final five-year point. The durability of these improvements supports scaling task-shifted trauma therapies in community settings, though the long-term advantage of exposure over counseling appears modest.
- Journal
- European journal of psychotraumatology (Q1)
- Published
- 14 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Jaco Rossouw, Elna Yadin, Debra Alexander, Soraya Seedat
- PMID
- 42734593
- DOI
- 10.1080/20008066.2026.2721926
Why clinicians should know about it
- Picked for Emergency Medicine (top studies of the week, 20 September 2026): High-quality evidence in a top journal
- Picked for Psychiatry and Mental Health (top studies of the week, 20 September 2026): Recent Psychiatry and Mental Health research from a high-quartile journal
Abstract
BACKGROUND: Cognitive-behavioural therapies with a trauma focus are effective in reducing posttraumatic stress disorder and other psychological distress in adolescents. Long-term follow-up data on adolescents treated for PTSD remain scarce, with few studies extending beyond 12 months after treatment completion. OBJECTIVE: To evaluate the maintenance of treatment gains in a comparative study of effectiveness of PE-A and SC up to 60 months post-treatment. METHOD: Sixty-three adolescents diagnosed with PTSD were randomly assigned to either treatment, provided by newly trained and supervised non-specialist health workers. The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale (CPSS). We report on the 60-month post-treatment follow-up, building on post-treatment, 3-month, 6-month, 12-month and 24-month post-treatment data that have been published previously. RESULTS: Participants in both treatment groups maintained a significant reduction in PTSD symptoms up to 60-months post-treatment (F (7, 343) = 2.86, p < .01). Participants receiving prolonged exposure experienced greater improvement on the CPSS at all follow-up assessment timepoints, except for the 60-month FU (p = .28; g = 0.33). CONCLUSION: Adolescents with PTSD continued to maintain treatment gains up to 60-months post-treatment. These data, along with findings from the original RCT, indicate that a brief treatment protocol (averaging 9 sessions of PE-A or SC) in a LMIC, task-shifted to be delivered by nurses without prior psychotherapy experience, led to lasting improvements in PTSD and comorbid symptoms for up to five years. The sustained benefits and improved functioning over the first few years post-treatment support expanding both treatments, especially PE-A, in community settings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.