Schumm Jeremiah A, Walter Kristen H, Bartone Anne S, Chard Kathleen M
Cincinnati VA Medical Center, Trauma Recovery Center, 3200 Vine Street, Cincinnati, OH 45220, USA; University of Cincinnati, Department of Psychiatry and Behavioral Neuroscience, 260 Stetson Street, Suite 3200, Cincinnati, OH 45219, USA.
Veterans Medical Research Foundation, VA San Diego Healthcare System, USA.
Behav Res Ther. 2015 Jun;69:75-82. doi: 10.1016/j.brat.2015.04.006. Epub 2015 Apr 16.
To maximize accessibility to evidence-based treatments for posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs (VA) has widely disseminated cognitive processing therapy (CPT) and prolonged exposure (PE) therapy to VA clinicians. However, there is a lack of research on veteran preferences when presented with a range of psychotherapy and medication options. This study uses a mixed-method approach to explore veteran satisfaction with a VA PTSD specialty clinic pre-treatment orientation group, which provides education about available PTSD treatment options. This study also tested differences in treatment preference in response to the group. Participants were 183 US veterans. Most were White, male, and referred to the clinic by a VA provider. Results indicated high satisfaction with the group in providing an overview of services and helping to inform treatment choice. Most preferred psychotherapy plus medications (63.4%) or psychotherapy only (30.1%). Participants endorsed a significantly stronger preference for CPT versus other psychotherapies. PE was significantly preferred over nightmare resolution therapy and present-centered therapy, and both PE and cognitive-behavioral conjoint therapy were preferred over virtual reality exposure therapy. Results suggest that by informing consumers about evidence-based treatments for PTSD, pre-treatment educational approaches may increase consumer demand for these treatment options.
为了最大限度地提高创伤后应激障碍(PTSD)基于证据的治疗方法的可及性,美国退伍军人事务部(VA)已向VA临床医生广泛传播认知加工疗法(CPT)和延长暴露疗法(PE)。然而,在提供一系列心理治疗和药物治疗选择时,缺乏关于退伍军人偏好的研究。本研究采用混合方法探讨退伍军人对VA创伤后应激障碍专科诊所治疗前定向小组的满意度,该小组提供有关可用的创伤后应激障碍治疗选择的教育。本研究还测试了该小组在治疗偏好方面的差异。参与者为183名美国退伍军人。大多数是白人男性,由VA提供者转介到诊所。结果表明,该小组在提供服务概述和帮助告知治疗选择方面获得了高度满意度。大多数人更喜欢心理治疗加药物治疗(63.4%)或仅心理治疗(30.1%)。与其他心理治疗相比,参与者对CPT的偏好明显更强。与噩梦解决疗法和以当前为中心的疗法相比,PE明显更受青睐,并且PE和认知行为联合疗法都比虚拟现实暴露疗法更受青睐。结果表明,通过向消费者介绍创伤后应激障碍的循证治疗方法,治疗前教育方法可能会增加消费者对这些治疗选择的需求。