Veterans Affairs Connecticut Health Care System.
Psychol Trauma. 2017 Aug;9(Suppl 1):35-41. doi: 10.1037/tra0000189. Epub 2016 Oct 6.
Veterans with posttraumatic stress disorder (PTSD) presenting for care with Veterans Affairs Health Care System (VA) tend not to engage in evidence-based psychotherapies (EBPs) despite widespread availability of these treatments. Though there is little evidence that "readiness for treatment" affects treatment choice, many VA providers believe that interventions to increase readiness would be helpful. This naturalistic study examined the effects of a 4-session education/treatment-planning group on treatment choice among veterans in a VA outpatient PTSD treatment program.
Treatment choices and completion rates of 114 veterans who received at least 1 session of the group (EG) were compared with those of 68 veterans who did not receive the group and received PTSD program treatment as usual (TAU). TAU and EG cases were matched on gender and service era.
Of 114 EG cases, 52 (45.6%) chose to receive EBPs, compared with 10 of 68 TAU cases (14.7%). These rates were significantly different, χ2(1) = 18.1, p < .0001. Among cases choosing EBPs, 52.2% of EG cases completed the EBPs as planned, compared with 60% of TAU cases. These percentages were not significantly different. Among EG cases choosing EBPs, lower likelihood of treatment completion was related to psychiatric medication prescription, presence of PTSD service connection, and higher overall service-connection level.
The education/treatment-planning group was associated with higher likelihood of selecting but not completing EBPs for PTSD. The decision to engage in trauma-focused treatment may be a different process from the decision to complete such treatment. (PsycINFO Database Record
尽管退伍军人事务部医疗保健系统(VA)广泛提供这些治疗方法,但患有创伤后应激障碍(PTSD)的退伍军人在寻求治疗时往往不接受基于证据的心理疗法(EBP)。尽管几乎没有证据表明“治疗准备情况”会影响治疗选择,但许多 VA 提供者认为增加准备情况的干预措施会有所帮助。这项自然主义研究调查了在 VA 门诊 PTSD 治疗计划中,对 114 名退伍军人进行为期 4 节的教育/治疗计划小组对治疗选择的影响。
将接受至少 1 次小组治疗(EG)的 114 名退伍军人的治疗选择和完成率与未接受小组治疗且接受 PTSD 项目常规治疗(TAU)的 68 名退伍军人进行比较。TAU 和 EG 病例在性别和服务时代方面相匹配。
在 114 名 EG 病例中,有 52 名(45.6%)选择接受 EBP,而 68 名 TAU 病例中有 10 名(14.7%)选择接受 EBP。这些比率有显著差异,χ2(1)= 18.1,p <.0001。在选择 EBP 的病例中,EG 病例中有 52.2%按计划完成 EBP,而 TAU 病例中有 60%完成。这些百分比没有显著差异。在选择 EBP 的 EG 病例中,较低的治疗完成可能性与精神药物处方、PTSD 服务连接的存在以及更高的整体服务连接水平有关。
教育/治疗计划小组与 PTSD 选择但不完成 EBP 的可能性增加有关。参与创伤焦点治疗的决定可能与完成此类治疗的决定不同。