Hope enhances treatment outcome of intensive trauma-focused treatment for PTSD

<b>Background:</b> Hope has been found to positively influence trauma-focused treatment outcomes and is associated with post-traumatic growth (PTG), which contributes to improved treatment efficacy.<b>Objective:</b> This observational study examined the extent to which hope predicts a decline in post-traumatic stress disorder (PTSD) symptoms and whether an increase in the level of hope predicts changes in PTSD symptoms. This study also investigated whether PTG mediates the relationship between hope and PTSD symptoms.<b>Method:</b> The sample included 339 participants (82.9% female) who were diagnosed with PTSD and underwent an intensive eight-day trauma-focused treatment programme consisting of eight sessions of prolonged exposure, eight sessions of EMDR therapy, physical activity, and psychoeducation. Assessments were performed pre-, mid-, and post-treatment using the PCL-5, HHI and PTGI. Linear Mixed and mediation models were used.<b>Results:</b> Hope significantly increased (Cohen's <i>d</i> = 0.47 at mid-treatment and post-treatment), and PTSD symptoms significantly decreased (Cohen's <i>d</i> = 1.72 at mid-treatment and 2.04 at post-treatment) during treatment. Both hope levels at the start of treatment and subsequent changes in hope during treatment significantly predicted a decline in PTSD symptoms (<i>p</i> < .01 and <i>p</i> < .001) and vice versa (<i>p</i> < .001). Pre-treatment PTG mediated the relationship between pre-treatment hope and mid-treatment PTSD symptoms but did not mediate the relationship between pre-treatment hope and post-treatment PTSD symptoms.<b>Conclusions:</b> These outcomes emphasise the critical importance of hope in PTSD treatment, highlighting its potential to bolster mental well-being and enhance the overall quality of life. More research is needed to gain more insight into the exact mechanisms underlying the interactions between hope, PTG and PTSD symptoms during treatment.