Hundt Natalie E, Harik Juliette M, Barrera Terri L, Cully Jeffrey A, Stanley Melinda A
Veterans Affairs South Central Mental Illness Research, Education and Clinical Center.
VA National Center for PTSD-Executive Division.
Psychol Trauma. 2016 Nov;8(6):728-735. doi: 10.1037/tra0000102. Epub 2016 Apr 11.
The purpose of this study was to assess how patient and provider factors influence the use of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD).
This study used a 2 × 2 survey design to assess providers' willingness to select EBPs for patients presented in clinical case vignettes. PTSD providers (N = 185) were randomized and asked to respond to 1 of 4 case vignettes in which the patients' age and alcohol use comorbidity were manipulated.
Results suggested that the majority of providers were favorable toward EBPs, with 49% selecting cognitive processing therapy (CPT) as the first-line intervention, 25% selecting prolonged exposure (PE), and 8% selecting Eye Movement Desensitization Reprocessing therapy. Provider characteristics, but not patient characteristics, influenced treatment selection. Cognitive-behavioral therapy (CBT) orientation, younger age, fewer years of experience, and more time spent treating patients with PTSD were positively related to EBP selection. Provider training in specific EBPs (CPT or PE) increased the likelihood of recommending these treatments as first-line interventions.
Taken together, these results suggest that providers are increasingly likely to view exposure-based EBPs for PTSD as effective, and that continued dissemination efforts to increase provider familiarity and comfort with these protocols will likely improve rates of EBP use across a variety of practice settings. (PsycINFO Database Record
本研究旨在评估患者因素和提供者因素如何影响创伤后应激障碍（PTSD）循证心理治疗（EBPs）的使用。
本研究采用2×2调查设计，以评估提供者为临床病例 vignettes 中呈现的患者选择 EBPs 的意愿。PTSD 提供者（N = 185）被随机分组，并被要求对4个病例 vignettes 中的1个做出回应，其中患者的年龄和酒精使用合并症被操纵。
结果表明，大多数提供者对 EBPs 持支持态度，49%的人选择认知加工疗法（CPT）作为一线干预措施，25%的人选择延长暴露疗法（PE），8%的人选择眼动脱敏再加工疗法。影响治疗选择的是提供者特征，而非患者特征。认知行为疗法（CBT）取向、较年轻、经验较少以及治疗 PTSD 患者花费的时间较多与选择 EBPs 呈正相关。提供者接受特定 EBPs（CPT 或 PE）的培训增加了将这些治疗推荐为一线干预措施的可能性。
综上所述，这些结果表明，提供者越来越有可能认为基于暴露的 PTSD EBPs 是有效的，并且持续的传播努力以提高提供者对这些方案的熟悉程度和舒适度可能会提高各种实践环境中 EBPs 的使用率。（PsycINFO 数据库记录）
