Cook Joan M, Dinnen Stephanie, Simiola Vanessa, Thompson Richard, Schnurr Paula P
Department of Psychiatry. She has numerous publications in the traumatic stress and geriatric mental health fields, including scientific papers on the phenomenology, assessment and treatment of older adult trauma survivors. She is a member of the American Psychological Association's Guideline Development Panel for PTSD. Yale School of Medicine and National Center for PTSD, West Haven, Connecticut.
Her research interests include trauma and posttraumatic stress disorder in older adult populations. Yale School of Medicine and National Center for PTSD, West Haven, Connecticut.
Prof Psychol Res Pr. 2014 Apr 1;45(2):136-142. doi: 10.1037/a0036183.
Providers ( = 198) from 38 Department of Veterans Affairs residential posttraumatic stress disorder treatment programs across the United States completed qualitative interviews regarding implementation of 2 evidence-based treatments: prolonged exposure and cognitive processing therapy. As part of this investigation, providers were asked how they decide which patients are appropriate for these treatments. Many indicated that they did not perceive any patient factors that dissuade their use of either evidence-based treatment. However, 3 broad categories emerged surrounding reasons that patients were perceived to be less suitable candidates for the treatments: the presence of psychiatric comorbidities, cognitive limitations, and low levels of patient motivation. Interestingly, providers' perceived reasons for limited or nonuse of a treatment did not correspond entirely to those espoused by treatment developers. Possible solutions to address provider concerns, including educational and motivational interventions, are noted.
来自美国各地38个退伍军人事务部创伤后应激障碍住院治疗项目的198名提供者，就两种循证治疗方法（延长暴露疗法和认知加工疗法）的实施情况完成了定性访谈。作为这项调查的一部分，提供者被问及他们如何确定哪些患者适合这些治疗。许多人表示，他们没有察觉到任何阻碍他们使用这两种循证治疗方法的患者因素。然而，围绕患者被认为不太适合接受这些治疗的原因，出现了三大类情况：存在精神疾病共病、认知限制和患者动机水平低。有趣的是，提供者认为的治疗使用受限或不使用的原因与治疗开发者所支持的原因并不完全一致。文中指出了解决提供者担忧的可能办法，包括教育和激励干预措施。
