Breaking down a long-standing barrier in mental healthcare, a landmark UK trial found that trauma-focused cognitive-behavioral therapy (CBTp) significantly reduced PTSD symptoms in patients with co-occurring psychosis. Half of patients in the therapy group achieved PTSD remission, compared to just 22% in the standard care group. The findings challenge the historical exclusion of psychosis patients from trauma-focused treatments.
For decades, patients with psychosis were routinely excluded from trauma-focused therapies — largely due to concerns about safety and tolerability. A major new UK randomized controlled trial is now pushing back on that assumption, showing that trauma-focused CBT for psychosis (CBTp) is not only safe but meaningfully effective for people living with both PTSD and psychosis.
The STAR trial enrolled over 300 adults across five UK sites between 2020 and 2024. Participants were randomized to receive either CBTp plus treatment as usual (TAU) or TAU alone. The CBTp program ran for 9 months, combining trauma memory reprocessing, stabilization, and engagement strategies across roughly 26 sessions in the first 6 months, followed by monthly boosters.
By the Numbers:
Why it matters: This is the largest trial ever conducted in this underserved population, and its results make a compelling case for expanding access to trauma-focused care for psychosis patients — a group that has long been denied evidence-based treatment options.
