A pilot study has shown that a new, tailored PTSD therapy programme has positive impacts for military veterans - significantly reducing symptoms of PTSD, anxiety, and depression.
The Cardiff University National Centre for Mental Health, funded by Health and Care Research Wales and the Office for Veterans' Affairs in the Ministry of Defence, worked with military veterans to adapt an existing PTSD therapy programme to meet the specific needs of military veterans - and an early study shows positive results.
Spring PTSD , is an evidence-based guided digital therapy that combines online CBT-TF content with therapist support. It was developed by researchers at the Traumatic Stress Group at National Centre for Mental Health.
In the new study, researchers from the Cardiff Centre learnt more about the triggers and causes of mental health problems and adapted Spring PTSD's current cutting-edge therapy for military veterans - conducting a pilot study to test its impact.
Dr Catrin Lewis, Spring researcher at the National Centre for Mental Health at Cardiff University, said: "Spring PTSD has been shown to be effective in civilian populations, but military trauma often comes with unique challenges, including more complex symptoms."
Rather than assuming a one-size-fits-all approach, we set out to adapt the existing programme specifically for veterans, with veterans playing a central role in shaping it.
The researchers invited eleven military veterans with lived experience of PTSD to share their thoughts on the Spring PTSD programme. They identified several key features that would make this digital programme more acceptable to other veterans:
- Relatability: veterans said that the audio narrator had to sound authentic and friendly.
- Representation: veterans said that they wanted to see diverse, realistic portrayals of military experiences and the veteran community.
- Identifiable design: a military-inspired aesthetic was seen as important in helping the programme feel familiar, meaningful, and trustworthy.
- Emotional regulation: many veterans described challenges in managing intense emotions and stressed the importance of developing emotional regulation skills before engaging in trauma-focused work.
These insights were used to shape the programme into the Spring Military PTSD programme – including integrated techniques from Enhanced Skills Training for Affective and Interpersonal Regulation (ESTAIR), placing greater emphasis on emotional regulation skills alongside trauma processing.
Once developed, a pilot study tested the effectiveness of the Spring Military PTSD programme with ten veterans with PTSD. They received regular guidance from a therapist throughout, receiving an average of just under four hours in total. The researchers measured how severe their PTSD was using a standardised scale called the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5).
Veterans also filled out self-report questionnaires about PTSD, anxiety, depression, and disturbances in self-organisation.
Among the eight participants who went on to complete the full programme, half no longer met diagnostic criteria for PTSD, six showed reliable improvement on clinician-rated PTSD symptoms, and veterans reported statistically significant reductions in PTSD, anxiety, depression, and disturbances in self-organisation.
Gareth Cross, Director of Health and Care Research Wales, said: "This pilot study provides encouraging evidence that a tailored digital therapy can address the complex mental health needs of military veterans with PTSD. It highlights how innovative digital interventions can expand access to high-quality, trauma-focused care. Health and Care Research Wales is proud to support work that strengthens the evidence base and could transform mental health services for veterans."
Professor Jon Bisson, Director of the National Centre for Mental Health, said: "Study findings demonstrate that guided digital therapy is acceptable to veterans and significantly reduces symptoms of military-related PTSD."
Spring Military PTSD has the potential to provide more choice and greater flexibility than face-to-face therapies, while also facilitating improvements to current care pathways.
Dr Lewis said: "This small pilot study provides encouraging early evidence that Spring Military-PTSD could be an effective and scalable treatment option for veterans.
"By combining evidence-based digital therapy with targeted and motivating therapist support, the intervention offers a promising way to increase access to trauma-focused therapy.
"Further research in larger participant samples will need to be completed to confirm its effectiveness and explore how it could be used more widely across veteran mental health services."
The research was funded by the Office for Veterans' Affairs in the Ministry of Defence as part of its work to improve treatments, techniques and pathways to meet veterans' physical and mental health needs.
