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Preventing Long Term Psychiatric Disability Among Those With Major Burn Injuries (SMART)

This study is ongoing, but not recruiting participants.
U.S. Department of Education
Information provided by (Responsible Party):
James A. Fauerbach, Johns Hopkins University Identifier:
First received: September 30, 2009
Last updated: January 19, 2017
Last verified: January 2017
The purpose of this study is to determine whether a newly developed, brief cognitive behavioral intervention, relative to supportive counseling, is effective in reducing acute stress disorder (ASD) and preventing post traumatic stress disorder (PTSD) and depression.

Condition Intervention
Stress Disorders, Post-Traumatic
Mood Disorders
Sleep Disorders
Behavioral: Cognitive Behavioral Therapy
Behavioral: Supportive Counseling

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Participant, Care Provider, Outcomes Assessor
Primary Purpose: Prevention
Official Title: Preventing Long Term Psychiatric Disability Among Those With Major Burn Injuries: the Safety, Meaning, Activation and Resilience Trial (SMART)

Resource links provided by NLM:

Further study details as provided by Johns Hopkins University:

Primary Outcome Measures:
  • Structured Clinical Interview for DSM IV: Mood and PTSD modules [ Time Frame: 1 week, 1 month and 6 months post-treatment ]

Secondary Outcome Measures:
  • Davidson Trauma Scale [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  • Patient Health Questionnaire - 9 (depression) [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  • Insomnia Severity Index [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  • Post Traumatic Growth Inventory [ Time Frame: 1 week, 1 month and 6 months post-treatment ]
  • McGill pain Questionnaire [ Time Frame: 1 week, 1 month and 6 months post-treatment ]

Estimated Enrollment: 130
Actual Study Start Date: October 16, 2007
Estimated Study Completion Date: December 2018
Estimated Primary Completion Date: October 15, 2018 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Cognitive Behavioral Therapy Behavioral: Cognitive Behavioral Therapy
CBT (4 sessions): 1) Cognitive therapy targeting key appraisals. 2) Prolonged exposure targeting trauma memories and reminders. 3) Active coping/Anxiety Management training mindfulness-based techniques.
Other Name: SMART
Active Comparator: Supportive Counseling Behavioral: Supportive Counseling
Supportive counseling (4 sessions): common factors among effective psychotherapies (e.g., empathy, positive regard)
Other Name: Usual Care

Detailed Description:

Importance: Burns are painful, life threatening and disfiguring. Severe psychological distress, pain and sleep disturbance are among the most common, enduring and disabling of secondary complications, however, no evidence based treatments exists for these complex problems in the acute burn care setting.

Design: Randomized, controlled effectiveness trial, group assignment blinded to baseline status, groups stratified by history of pre-existing psychiatric disorder.

Objectives. To develop the Safety, Meaning, Activation and Resilience Training (SMART) protocol; To evaluate its short and long-term effectiveness, relative to viable placebo, Supportive Counseling (SC), in improving key dependent measures (e.g., ASD, PTSD), mediators, and, enhancing health and function outcomes.

Setting: A leading edge, State-dedicated, regional burn center in a major, metropolitan teaching hospital serving diverse residents from large urban settings, small towns and remote rural areas.

Interventions: SMART (focused cognitive-behavioral therapy with training in anxiety management, and treatment with prolonged exposure and cognitive restructuring) will be contrasted with SC (non-directive empathy, warmth, positive regard).

Primary Outcome Measures: Health (psychological distress, sleep, pain), function (physical, psychological, social), costs (direct and indirect).


Ages Eligible for Study:   18 Years to 70 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • 18 to 70 years old
  • acute burn injury
  • exceeding criteria on screening instrument at baseline (in-hospital prior to treatment): Acute Stress Disorder Scale (ASDS score ≥ 37: acute posttrauma distress).

Exclusion Criteria:

  • Age less than 18 or greater than 70 years
  • Presence of a significant cognitive / neurological or psychiatric condition precluding informed consent (e.g., psychosis, acute suicidality)
  • Inability to communicate in English
  • intubated or sedated
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00988104

United States, Maryland
Johns Hopkins Burn Center
Baltimore, Maryland, United States, 21224
Sponsors and Collaborators
Johns Hopkins University
U.S. Department of Education
Principal Investigator: James A Fauerbach, PhD Johns Hopkins University
Principal Investigator: Una D McCann, MD Johns Hopkins University
  More Information

Additional Information:

Responsible Party: James A. Fauerbach, Associate Professor, Johns Hopkins University Identifier: NCT00988104     History of Changes
Other Study ID Numbers: H133A070045
NIDRR H133A070045
H133A070045 ( Other Grant/Funding Number: NIDILRR )
Study First Received: September 30, 2009
Last Updated: January 19, 2017

Keywords provided by Johns Hopkins University:
Behavior Therapy
Randomized Controlled Trial

Additional relevant MeSH terms:
Mood Disorders
Sleep Wake Disorders
Stress Disorders, Post-Traumatic
Pathologic Processes
Mental Disorders
Nervous System Diseases
Neurologic Manifestations
Signs and Symptoms
Stress Disorders, Traumatic
Trauma and Stressor Related Disorders
Wounds and Injuries processed this record on March 28, 2017