Feasibility of intensive prolonged exposure for PTSD: a pragmatic pilot study in Swedish public outpatient psychiatry

Abstract Background Prolonged exposure (PE) is an established treatment for PTSD, but outcomes are often limited by dropout and delivery constraints. This study evaluated the feasibility, acceptability, and preliminary effectiveness of intensive-format PE (I-PE) delivered as a pragmatic intervention in a Swedish psychiatric outpatient setting. Methods Thirty-three adults meeting the diagnostic criteria for PTSD were enrolled in a single-center, uncontrolled pragmatic feasibility trial embedded in routine outpatient care in Sweden. I-PE comprised five consecutive days of therapist-guided treatment, followed by three individual booster sessions at weeks 2, 4, and 8. The primary objectives were to assess feasibility through reach, retention, treatment adherence, satisfaction, and safety. Clinical outcomes included clinician-rated PTSD severity with the Clinician-Administered PTSD Scale for DSM-5 at baseline and 6-month follow-up; self-reported PTSD with the PTSD Checklist for DSM-5 at baseline, posttreatment, and 6-month follow-up; complex PTSD sympt