Spring Military-PTSD: development and pilot evaluation of a guided digital therapy for military veterans with post-traumatic stress disorder (PTSD)

Lewis, Catrin ORCID: https://orcid.org/0000-0002-3818-9377, Thomas, Bronwen, Wong, Janice Sing Yun, Cloitre, Marylene, Karatzias, Thanos, Roberts, Neil P., Kitchiner, Neil J. ORCID: https://orcid.org/0000-0003-0499-9520 and Bisson, Jonathan I. ORCID: https://orcid.org/0000-0001-5170-1243 2026. Spring Military-PTSD: development and pilot evaluation of a guided digital therapy for military veterans with post-traumatic stress disorder (PTSD). European Journal of Psychotraumatology 17 (1) , 2605806. 10.1080/20008066.2025.2605806

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Abstract

Background: Cognitive behavioural therapy with a trauma focus (CBT-TF) is the gold-standard treatment for military post-traumatic stress disorder (PTSD), but access is limited by high costs, therapist shortages, and the demands of in-person delivery. Guided digital CBT-TF, delivered via an app or website with therapist support, offers a scalable alternative. Objective: This study aimed to adapt Spring PTSD, an evidence-based guided digital therapy, for military veterans and conduct an initial pilot test of the adapted version. Method: A two-stage process was used. In Stage 1, veterans with lived experience of PTSD (n = 11) participated in focus groups to guide adaptations. Key themes included the need for a relatable narrator, authentic military representation, diverse visuals, and military-inspired design. Veterans also emphasised addressing emotional regulation. These insights shaped the development of Spring Military-PTSD, which incorporated techniques from Enhanced Skills Training for Affective and Interpersonal Regulation (ESTAIR). In Stage 2, treatment-seeking veterans with PTSD (n = 10) took part in a pilot study that collected qualitative and quantitative data. The primary outcome was change in PTSD severity measured by the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Participants received an average of 3 h and 50 min of therapist support. Results: Eight participants completed the pilot; two dropped out. Of the completers, four no longer met diagnostic criteria for PTSD, and six showed reliable improvement on CAPS-5. Statistically significant reductions were also seen in self-reported PTSD, disturbance in self-organisation (DSO), anxiety, and depression. Qualitative feedback supported the relevance and acceptability of the intervention. Conclusions: Findings provide preliminary evidence for the efficacy and acceptability of Spring Military-PTSD. The adapted intervention shows promise as a scalable and engaging treatment for veterans with PTSD. Further research is warranted to evaluate its effectiveness and potential for broader implementation.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine Research Institutes & Centres > National Centre for Mental Health (NCMH)
Publisher:	Taylor and Francis Group
ISSN:	2000-8066
Date of First Compliant Deposit:	16 February 2026
Date of Acceptance:	5 December 2025
Last Modified:	16 Feb 2026 12:45
URI:	https://orca.cardiff.ac.uk/id/eprint/184881

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