Testing two therapy approaches for veterans with PTSD and suicide risk

This trial is testing two different therapy approaches for veterans who have both PTSD and recent suicidal thoughts or behaviors. One approach combines Dialectical Behavior Therapy (DBT)—which focuses on managing suicidal crises and emotions—with a specialized exposure therapy for PTSD. The other approach uses exposure therapy for PTSD with added suicide safety planning. The study will compare which treatment works better and is safer for this high-risk group.

Many effective therapies for PTSD exist, but doctors have historically avoided using them with people at immediate risk for suicide because there wasn't enough research proving they were safe in this situation. This creates a dangerous gap: veterans who need PTSD treatment the most often can't access it. This trial aims to fill that gap by rigorously testing both approaches so doctors will have clear guidance on how to safely treat PTSD in people at elevated suicide risk.