Effectiveness of Cognitive Processing Therapy Among Patients with Comorbidity of Alcohol Use Disorders and Post Traumatic Stress Disorder: An Intervention Study of Rehabilitation Centres in Nairobi and its Environs

Margaret Sirima, Ph.D. in Clinical Psychology Candidate; Caroline Ayuya, Ph.D; & Philemon Yugi, Ph.D., Daystar University, Kenya

The comorbidity of post-traumatic stress disorder (PTSD) and Alcohol use disorder (AUD) is well documented. High rates of relapse post- treatment of AUD are often witnessed, even in patients seeking help voluntarily.  The purpose of this study was to establish whether treating PTSD with Cognitive Processing Therapy (CPT) in AUD patients admitted in residential rehabilitation centers reduces PTSD symptoms and consequently reduces tendencies for relapse. The study employed a quasi-experimental design with experimental and control arms. A total of 123 respondents participated, 63 in the experimental group and 60 in the control group, consecutive sampling technique was used.  PCL-5 was used at baseline, midline and endline to collect data. Descriptive and inferential statistics was used to summarize the findings. Paired T-test and repeated measures ANOVA were used to test for efficacy of CPT in reducing PTSD Symptoms and relapse.  The study was done in rehabilitation Centres in Nairobi and its environs. The participants were followed at 3 months after treatment and discharge for relapse tendencies. At the end of the treatment, there was a significant reduction in PCL mean score from 38.33 to 21.46 in the group treated with CPT. In contrast, the control group showed a slight increase in mean scores from 46.98 at baseline to 48.48 at the endline. The number of respondents in the experimental group who relapsed into alcohol use were 31.7% (20) while in the control group, 61.7% (37) respondents relapsed. There was a statistically significant difference between the two groups (p=<0.0001). The integration of CPT with the traditional addiction treatment approach for AUD proved to be effective in the reduction of PTSD symptoms. Additionally, CPT was associated with reduced incidences of relapse of alcohol use in the experimental group compared to those in the control group. The researcher recommends that it should be mandated in policy that assessment for PTSD and use of CPT be incorporated into the treatment modalities for AUD in rehabilitation centers in Kenya.

Keywords: Cognitive Processing Therapy, Alcohol Use Disorder, Post-Traumatic Stress Disorder, Rehabilitation, Relapse Prevention, Trauma History