ISRCTN ISRCTN91345822
DOI https://doi.org/10.1186/ISRCTN91345822
Submission date
22/01/2020
Registration date
23/01/2020
Last edited
10/05/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Many people who experience traumatic events are left with distressing symptoms afterwards. Post-traumatic stress disorder (PTSD) is a common mental health problem and many people are helped by talking about their experiences with a therapist. Despite this, some people still struggle with their symptoms, and so it is important that the researchers can create new ways of treating PTSD to help more people. In this study, the researchers are inviting people who are currently struggling with their mental health to receive either a new kind of talking therapy called the Rewind Technique, or to join a waiting list to then receive the usual psychological treatments used in PTSD, such as cognitive behaviour therapy (CBT) and Eye Movement Desensitisation Reprocessing therapy (EMDR). As a one-to-one talking therapy the Rewind Technique has many things in common with current therapies available on the NHS, but the therapy asks patients to address your difficult experiences in a different way. Our goal is to find out if the Rewind Technique works better than for those people who join a waiting list to receive CBT or EMDR. The researchers hope that the results will be used to bring forward new treatments for NHS patients.

Who can participate?
Anyone over the age of 18 with PTSD.

What does the study involve?
Participants will be randomly allocated to receive The Rewind Technique immediately or after an eight week delay. The researchers will collect information from participants before, during and after their courses of therapy, using a combination of interviews and questionnaires. Comparing the results before and after will allow us to see if the Rewind Technique is an acceptable treatment for those with PTSD.

What are the possible benefits and risks of participating?
There is some emerging evidence for The Rewind Technique and so it may help with PTSD symptoms. While there are no known side effects or risks of The Rewind Technique some people may find addressing their experiences distressing. Participants will be monitored throughout treatment by their therapist who can provide support. Participants are also free to leave the study at any time, without giving a reason.

Where is the study run from?
Cardiff University, UK

When is the study starting and how long is it expected to run for?
November 2019 to April 2022 (updated 11/05/2021, previously: June 2021)

Who is funding the study?
Cardiff University, UK

Who is the main contact?
Dr Laurence Astill Wright (public)
laurencewright@doctors.org.uk
Prof Jonathan Bisson (scientific)
BissonJI@cardiff.ac.uk

Contact information

Dr Laurence Astill Wright
Public

School of Medicine, UHW Main Building, Heath Park, Cardiff
Cardiff
CF14 4XN
United Kingdom

ORCiD logoORCID ID 0000-0001-8324-1229
Phone +44 (0)29 2068 8113
Email laurencewright@doctors.org.uk
Prof Jonathan Bisson
Scientific

School of Medicine, UHW Main Building, Heath Park, Cardiff
Cardiff
CF14 4XN
United Kingdom

ORCiD logoORCID ID 0000-0001-5170-1243
Phone +44 (0)292 068 8321
Email BissonJI@cardiff.ac.uk

Study information

Study designTwo-armed phase 2 exploratory Interventional randomized controlled trial
Primary study designInterventional
Secondary study designRandomised cross over trial
Study setting(s)Community
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleThe RETURN Study: REconsolidaTion Using RewiNd
Study acronymRETURN
Study hypothesisThe Rewind Technique will be superior to a waitlist control group in this crossover randomised controlled trial
Ethics approval(s)We will have submitted ethical approval via IRAS by mid-October 2019.
Sponsorship reference number: SPON1791-19
ConditionPost Traumatic Stress Disorder (PTSD)
InterventionThis is a cross-over waitlist controlled RCT.
The total duration of treatment will be three 60 minute sessions. One arm of the study will start Rewind post-randomisation, with the second group remaining on a waitlist for 8 weeks, and then starting Rewind at 8 weeks following the 8 week outcome assessment.
Follow up will occur at 8 and 16 weeks.
The randomisation process will be computer-based random allocation.

The intervention will comprise three 60-minute sessions following a protocol developed by David Muss which has been modified by David Muss and the research team following feedback from therapists. This will then be administered by experienced and trained psychological therapists under the supervision of David Muss and the Cardiff and Vale Traumatic Stress Service. The participant will be introduced to the technique and the theory behind it before being asked to imagine he/she is in a cinema watching a film of her/his traumatic event as if it had been captured on CCTV. Rather than the film start at the trauma itself the person with PTSD is told the film starts before the traumatic event took place and is then followed by the regular intrusive recall which includes all the images, sounds and smells plus (if this is part of the regular recall) what could have happened next but didn't. Once the recall ends, the sufferer is (metaphorically) invited to enter the screen and at that point the film is rewound at speed back to the exact starting point (where all was well before the trauma). The forward part of the loop should not take longer than 2 minutes, the rewound part about 10 seconds. This usually requires the person with PTSD to practise the technique a few times before feeling confident it is being undertaken as intended.
Intervention typeBehavioural
Primary outcome measurePTSD symptom severity measured using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) at 8 and 16 weeks post-randomisation
Secondary outcome measuresMeasured at 8 and 16 weeks post-randomisation (unless otherwise noted):
1. PTSD symptoms (DSM-5) measured using the PTSD Checklist (PCL-5) at the start of each treatment session
2. ICD-11 PTSD and complex PTSD symptoms measured using the International Trauma Questionnaire
3. DSM-5 depressive symptoms measured using the PHQ-9 at the start of each treatment session
4. Symptoms of generalised anxiety disorder measured using the GAD-7 at the start of each treatment session
5. Symptoms of insomnia measured using the Insomnia Severity Index
6. Health-related quality of life measured using the EQ5D-5L
7. An intervention acceptability questionnaire will be administered by the Rewind therapist at the end of the final session to gauge acceptability and feasibility of the intervention, as perceived by the participant
Overall study start date01/10/2019
Overall study end date01/04/2022

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants40
Total final enrolment40
Participant inclusion criteria1. Adults aged 18 years or over who are fluent in English
2. Able to provide informed consent
3. Meet DSM-5 criteria for PTSD
Participant exclusion criteria1. Current psychotic or bipolar disorder
2. Traumatic brain injury
3. Substance dependence
4. Acute suicidal ideation
5. Personality disorder
6. Learning disability
7. Previous receipt of an adequate trial of trauma-focused psychological treatment for PTSD
8. Change to the type or dosage of psychotropic medication within one month of baseline assessment
Recruitment start date01/10/2020
Recruitment end date01/12/2021

Locations

Countries of recruitment

  • United Kingdom
  • Wales

Study participating centre

Cardiff University
School of Medicine
UHW Main Building
Heath Park
Cardiff
CF14 4XN
United Kingdom

Sponsor information

Cardiff University
University/education

School of Medicine
UHW Main Building
Heath Park
Cardiff
CF14 4XN
Wales
United Kingdom

Phone +44 (0)29 2068 8113
Email medicine@cardiff.ac.uk
Website https://www.cardiff.ac.uk/medicine/research/divisions/psychological-medicine-and-clinical-neurosciences
ROR logo "ROR" https://ror.org/03kk7td41

Funders

Funder type

University/education

Cardiff University
Private sector organisation / Universities (academic only)
Location
United Kingdom

Results and Publications

Intention to publish date01/07/2023
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planWe will present the work at academic conferences via oral and poster presentations, and facilitating workshops, engaging practising clinicians and hoping to inform their practice. Publishing the work in a prestigious, open access academic journal will increase the publicity of our research and inform the academic debate.
IPD sharing planThe current data sharing plans for this study are unknown and will be available at a later date

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 28/01/2021 12/08/2021 Yes No
Results article 12/10/2023 10/05/2024 Yes No

Editorial Notes

10/05/2024: Publication reference added.
13/12/2021: The total final enrolment was added.
12/08/2021: Publication reference added.
11/05/2021: The following changes were made to the trial record:
1. The recruitment end date was changed from 01/05/2021 to 01/12/2021.
2. The overall end date was changed from 01/10/2021 to 01/04/2022.
3. The intention to publish date was changed from 01/01/2022 to 01/07/2022.
4. The plain English summary was updated to reflect these changes.
5. A study contact was removed.
27/11/2020: The following changes were made:
1. The recruitment end date was changed from 01/04/2021 to 01/05/2021.
2. The overall trial end date was changed from 01/06/2021 to 01/10/2021.
3. The intention to publish date was changed from 01/12/2021 to 01/01/2022.
03/11/2020: The following changes were made to the trial record:
1. The recruitment start date was changed from 01/05/2020 to 01/10/2020.
2. The recruitment end date was changed from 01/11/2020 to 01/04/2021.
3. The overall trial end date was changed from 01/01/2021 to 01/06/2021.
4. The intention to publish date was changed from 01/09/2020 to 01/12/2021.
14/04/2020: The recruitment start date has been changed from 01/02/2020 to 01/05/2020.
23/01/2020: Trial’s existence confirmed by Cardiff University.