South Texas Veterans Health Care System.
National Center for PTSD, Palo Alto Veterans Health Care System.
Psychol Serv. 2018 Nov;15(4):442-452. doi: 10.1037/ser0000143. Epub 2017 Mar 16.
Significant changes in national health policy, like the Veterans Choice Act, have created growing opportunities for veterans to receive care outside of the Veterans Administration (VA), yet little is known about the attitudes and practices in PTSD care of community providers, particularly their use of evidence-based psychotherapies (EBPs). The authors assessed psychotherapy practices of community providers serving veterans with PTSD in Texas. They surveyed Texas mental health providers regarding their patient population, practice setting, and posttraumatic stress disorder (PTSD)-related screening, assessment, and treatment practices. They identified providers from state licensing board rosters and included a stratified sample of social workers, marriage and family therapists, and professional counselors (500 each), all psychologists with available email addresses (n = 3,986), and 106 providers known to have completed state-sponsored training for 1 of the EBPs for PTSD, cognitive processing therapy. Four hundred sixty-three eligible respondents returned surveys (15% response rate). Providers reported treating a mean of 7.9 veterans with PTSD in the past year (range = 0-200; SD = 20.5), using a variety of therapeutic approaches for PTSD. Only 15.0% of providers reported regularly conducting psychotherapy for PTSD following a treatment manual, and fewer than half reported any use of EBPs for PTSD with patients. Although many veterans are receiving treatment for PTSD in the community, many community-based mental health providers in Texas do not consistently use recommended treatments for PTSD. These findings may suggest an important opportunity for VA to engage and partner with community providers to achieve high-quality care for veterans. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
国家卫生政策的重大变化,如退伍军人选择法案,为退伍军人在退伍军人管理局(VA)之外获得医疗服务创造了更多的机会,但对于社区提供者在创伤后应激障碍(PTSD)护理方面的态度和实践,特别是他们对循证心理疗法(EBPs)的使用情况,知之甚少。作者评估了德克萨斯州为 PTSD 退伍军人提供服务的社区提供者的心理治疗实践。他们调查了德克萨斯州的心理健康提供者,了解他们的患者群体、实践环境以及与创伤后应激障碍相关的筛查、评估和治疗实践。他们从州许可委员会名册中确定了提供者,并包括了社会工作者、婚姻和家庭治疗师以及专业顾问的分层样本(各 500 名)、所有有电子邮件地址的心理学家(n = 3986),以及 106 名已知完成了州赞助的 1 种 PTSD 循证治疗认知加工疗法培训的提供者。463 名符合条件的受访者返回了调查(15%的回复率)。提供者报告说,在过去一年中,他们平均治疗了 7.9 名 PTSD 退伍军人(范围= 0-200;SD = 20.5),采用了多种治疗 PTSD 的方法。只有 15.0%的提供者报告说,他们定期按照治疗手册进行 PTSD 心理治疗,不到一半的人报告说在治疗患者时使用过任何 PTSD 的 EBPs。尽管许多退伍军人在社区接受 PTSD 治疗,但德克萨斯州的许多社区心理健康提供者并没有始终如一地使用 PTSD 的推荐治疗方法。这些发现可能表明退伍军人事务部有一个重要的机会,可以与社区提供者合作,为退伍军人提供高质量的护理。(PsycINFO 数据库记录(c)2018 APA,保留所有权利)。