An interventional study of Psychological-cognitive reprocessing procedure (P-CRP). and Expressive Narrative and Symbolic Drawing (ENSD) in Trauma and Stress Related Disorders, Grief (Traumatic Grief and Existential Grief) and Stress Disorder - Post-traumatic (Acute), sponsored by Zahide Betül Baydar. Completed at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-07-14.
Sponsored by Zahide Betül Baydar · Not applicable, Interventional, and Treatment
The purpose of this retrospective study was to evaluate the effectiveness of a new psychotherapy technique called Psychological Cognitive Reprocessing Procedure (P-CRP) in treating trauma symptoms. The P-CRP intervention was developed and manualized by the principal investigator (Z.B.Baydar). Participants were randomly assigned to either the P-CRP intervention group, an active control group, or a waitlist condition. The study aimed to determine if this new method, which focused on episodic buffer processing, significantly reduced trauma-related psychological distress compared to standard approaches. Data collected during the intervention phase were analyzed to assess the efficacy of the P-CRP technique.
53 studies on the registry are indexed under Trauma and Stressor Related Disorders; 28 are open to participants now.
This study's enrollment of 43 is below the median of 63 across 48 interventional studies indexed under Trauma and Stressor Related Disorders.
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Individuals were excluded if they had:
Individuals were included if they had:
The P-CRP was the experimental group receiving four session the intervention. The Psychological-Cognitive Reprocessing Procedure (P-CRP) is a brief and a neuro-psychological intervention based on the episodic buffer model. This process facilitates the separation of cognitions from automatic processing and pulls traumatic fragments into the episodic buffer through simultaneous neuronal firing. This integration helps resolve the semantic fragmentation caused by trauma, allowing for cognitive reintegration and meaning making.
Behavioral: Psychological-cognitive reprocessing procedure (P-CRP).
Control participants received four session a narrative-based expressive and symbolic drawing protocol. The intervention delivered to the control group can be characterized as an active, experiential, projective, and sensory-supported approach.
Behavioral: Expressive Narrative and Symbolic Drawing (ENSD)
Participants in this group did not receive any active psychological intervention during the study period. They completed the pre-test and follow-up assessments at the same time intervals as the intervention groups. Following the completion of the follow-up phase, participants in the wait-list group were offered a psychological intervention protocol based on the study's findings to ensure ethical treatment standards.
Unlike traditional approaches, the traumatic imagery is not directly targeted in the first session. The intervention begins with the silent repetition of a word or phrase representing the core negative belief associated with the traumatic experience. . During each 1-minute set, bilateral stimulation (synchronized tapping on the shoulders only) is applied, allowing the client to process the traumatic material through spontaneously emerging associations selected by the mind itself. Rather than relying on external direction, the protocol activates internal self-regulation capacities. In this respect, it aims to promote semantic and symbolic reorganization, differing from classical cognitive restructuring or desensitization-based methods. The decision about which aspect of the experience will be processed or desensitized is determined by the client's own mental flow, thereby reinforcing a sense of trust in the mind's capacity despite the traumatic history.
Following initial anamnesis and psychoeducation, clients recounted their trauma and drew a self-selected symbol of the event using their non-dominant hand. Each session involved discussing the memory and updating this symbol to facilitate indirect processing through creative expression.
The Impact of Event Scale -Revised (IES-R)
The IES-R is a 22-item self-report scale designed to assess the psychological impact of traumatic experiences across three subdimensions: intrusion, avoidance, and hyperarousal. Items are rated on a 5-point Likert scale (0 = not at all to 4 = extremely) based on symptom frequency over the past seven days. Total scores range from 0 to 88, where higher scores indicate greater severity of post-traumatic stress symptoms. According to the literature, scores of 33 and above suggest a probable PTSD diagnosis. The Turkish adaptation was used, which demonstrated high validity and reliability.
Time frame: Baseline (Week 0), Post-intervention (Week 6), and Follow-up (Week 10) .
State-Trait Anxiety Inventory (STAI).
At the beginning of the scale, four demographic questions are included (name, gender, age, and occupation). The instrument uses a four-point Likert-type response format. The State Anxiety subscale consists of 20 items rated on a scale from (1) Not at all to (4) Very much so. The Trait Anxiety subscale also contains 20 items, with response options ranging from (1) Almost never to (4) Almost always. Cronbach's alpha coefficients reported in the Turkish adaptation were α = .72 for the State Anxiety subscale, α = .67 for the Trait Anxiety subscale, and α = .70 for the total scale; overall reliability values for the instrument have been reported to fall between α = .60 and α = .80.
Time frame: Baseline (Week 0), Post-intervention (Week 6), and Follow-up (Week 10)
The Body Sensations Questionnaire (BSQ).
It is a 17-item self-report measure assessing fear of bodily sensations associated with arousal and panic. Cronbach's alpha for the scale is reported as .92; in the current study, internal consistency was α = .93.
Time frame: Baseline (Week 0), Post-intervention (Week 6), and Follow-up (Week 10)
The Positive and Negative Affect Schedule (PANAS)
Scale is a 20-item scale consisting of 10 positive and 10 negative affect items. In the present study, Cronbach's alpha coefficients were α = .86 for Positive Affect and α = .82 for Negative Affect.
Time frame: Baseline (Week 0), Post-intervention (Week 6), and Follow-up (Week 10)
Plan to share: No — The datasets generated and analyzed during the current study are not publicly available due to participant confidentiality and ethical restrictions established in the informed consent agreement. However, de-identified data may be made available from the corresponding author (\[Z.B.B\]) upon reasonable request for scientific purposes.
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