Service Delivery

Massed Prolonged Exposure for PTSD in Two Firefighters: Preliminary Case Study Findings.

Zwetzig et al. (2022) · Behavior modification 2022
★ The Verdict

Daily prolonged exposure slashed PTSD symptoms for two firefighters and could cut dropout for your weekly-no-show clients.

✓ Read this if BCBAs working with first responders or any adult PTSD clients who miss appointments.
✗ Skip if Clinicians serving only kids or clients with severe aggression.

01Research in Context

01

What this study did

Two firefighters with PTSD got Massed Prolonged Exposure. They met every day for ten days instead of once a week.

Doctors tracked their PTSD scores before and after the crash course.

02

What they found

Both firefighters saw big drops in PTSD symptoms. Daily sessions kept them from dropping out.

The short schedule worked even though it was intense.

03

How this fits with other research

Bellon-Harn et al. (2020) did the same "squeeze-it-in" trick with PEERS social skills. Teens with autism got the same gains in half the time when sessions were doubled up.

Victuri et al. (2022) also ran a tiny adult study. Three moms cut anxiety and depression with a brief behavioral package, showing small-n designs can still yield clear signals.

Whaling et al. (2025) ran a two-kid VR case study and saw big behavior drops too. Together these papers say "short and sweet" can work across very different problems.

04

Why it matters

If a client keeps canceling weekly PTSD sessions, offer a daily mini-block instead. You might keep them in care and still see symptom drops. Start with one willing firefighter, cop, or nurse and track PTSD scores each day.

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→ Action — try this Monday

Pitch a 10-day daily PE block to one no-show client and graph their PTSD checklist before and after.

02At a glance

Intervention
other
Design
case study
Sample size
2
Population
other
Finding
positive

03Original abstract

Military service members and first responders experience significant trauma exposure in the line of duty. Service members who transition to first-responder positions may be at an increased risk for developing PTSD due to the cumulative effects of trauma exposure. A common criticism of the standard delivery methods for most evidence-based treatments for PTSD is high dropout rates. Massed-prolonged exposure (Massed-PE) has been demonstrated to be efficacious and reduces dropouts by about 50%. This case study is the first of its kind to specifically assess the clinical utility of using Massed-PE to treat PTSD in two firefighters. Results from this case study indicate that both firefighters had significant reductions in their PTSD symptoms. Massed-PE may be an effective approach to treating PTSD in firefighters and may help overcome some of the barriers of conventional treatment delivery. Additional controlled research is needed to further evaluate this promising treatment approach in firefighter populations.

Behavior modification, 2022 · doi:10.1177/01454455211011977