Stecker Tracy, McHugo Gregory, Xie Haiyi, Whyman Katrina, Jones Meissa
Psychiatr Serv. 2014 Oct;65(10):1232-7. doi: 10.1176/appi.ps.201300433.
Many service members do not seek care for mental health and addiction problems, often with serious consequences for them, their families, and their communities. This study tested the effectiveness of a brief, telephone-based, cognitive-behavioral intervention designed to improve treatment engagement among returning service members who screened positive for posttraumatic stress disorder (PTSD).
Service members who had served in Operation Enduring Freedom or Operation Iraqi Freedom who screened positive for PTSD but had not engaged in PTSD treatment were recruited (N=300), randomly assigned to either control or intervention conditions, and administered a baseline interview. Intervention participants received a brief cognitive-behavioral therapy intervention; participants in the control condition had access to usual services. All participants received follow-up phone calls at months 1, 3, and 6 to assess symptoms and service utilization.
Participants in both conditions had comparable rates of treatment engagement and PTSD symptom reduction over the course of the six-month trial, but receiving the telephone-based intervention accelerated service utilization (treatment engagement and number of sessions) and PTSD symptom reduction.
A one-time brief telephone intervention can engage service members in PTSD treatment earlier than conventional methods and can lead to immediate symptom reduction. There were no differences at longer-term follow-up, suggesting the need for additional intervention to build upon initial gains.
许多军人不寻求针对心理健康和成瘾问题的治疗，这往往给他们自己、他们的家庭以及他们的社区带来严重后果。本研究测试了一种简短的、基于电话的认知行为干预措施的有效性，该干预旨在提高创伤后应激障碍（PTSD）筛查呈阳性的退伍军人的治疗参与度。
招募曾在持久自由行动或伊拉克自由行动中服役、PTSD筛查呈阳性但未接受PTSD治疗的军人（N = 300），随机分配至对照组或干预组，并进行基线访谈。干预组参与者接受简短的认知行为疗法干预；对照组参与者可获得常规服务。所有参与者在第1、3和6个月接受随访电话，以评估症状和服务利用情况。
在为期六个月的试验过程中，两组参与者的治疗参与率和PTSD症状减轻率相当，但接受基于电话的干预加快了服务利用（治疗参与度和疗程数）以及PTSD症状的减轻。
一次性简短电话干预能够比传统方法更早地促使军人参与PTSD治疗，并能立即减轻症状。长期随访中未发现差异，这表明需要进行额外干预以巩固初始成效。
