Limitations
This study has several limitations. First, the study end point of 3 months post intervention precluded determination of even longer-term sustained effects of the interventions. Second, the CAPS-5 assessors were not blinded, introducing a risk of bias. Third, participants may have participated in unreported CIH modalities or psychotherapy that could have confounded the results. Finally, the final cohort at site 1 and the only cohort at site 2 were conducted during the COVID-19 pandemic, introducing additional stressors, isolation, restricted access to health care, and a pivot of study procedures to virtual delivery, all potential confounders of study data during that time.