Massachusetts General Hospital.
Uniformed Services University of the Health Sciences.
Psychol Trauma. 2019 Oct;11(7):793-801. doi: 10.1037/tra0000427. Epub 2019 Jan 28.
Extensive research supports the use of prolonged exposure (PE) and cognitive processing therapy (CPT), for posttraumatic stress disorder (PTSD) in veterans and service members. PE and CPT have been disseminated nationally across the Department of Veterans Affairs (VA) facilities. Many service members and veterans receive care outside the VA where access to these gold standard psychotherapies can be limited. This paper presents a novel program developed to train community providers in the use of PE and CPT and their application to veterans with PTSD through the use of a medium-touch approach to consultation.
Four 2-day trainings (2 in PE, 2 in CPT) were delivered to a total of 170 participants over an 8-month period. A subset of approximately 10 providers per training (n = 42) received 6 months of weekly, group phone consultation following the 2-day training. All providers were assessed pre- and posttraining, as well as 3 and 6 months after their training. Outcomes for the training workshop alone and the training plus 6 months of consultation were compared.
While participant knowledge, t = -22.57, p < .001 and comfort (χ² = 74.00, p < .001) with PE and CPT significantly increased immediately following the 2-day training, those who received consultation were more likely to implement (χ² = 20.88, p < .001) and either complete or be close to completing PE or CPT with patients (χ² = 20.57, p < .001) 6 months following training.
Despite some limitations, these preliminary data support that consultation is an important component to include in PTSD therapy training and implementation in the community. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
大量研究支持将延长暴露疗法(PE)和认知加工疗法(CPT)用于退伍军人和军人的创伤后应激障碍(PTSD)。PE 和 CPT 已在退伍军人事务部(VA)的全国范围内得到推广。许多军人和退伍军人在 VA 之外接受治疗,在那里获得这些黄金标准心理疗法的机会可能有限。本文介绍了一种新方案,该方案旨在通过使用中度接触式咨询来培训社区服务提供者使用 PE 和 CPT,并将其应用于 PTSD 退伍军人。
在 8 个月的时间里,共向 170 名参与者提供了 4 次为期 2 天的培训(2 次 PE,2 次 CPT)。在每次 2 天的培训之后,大约有 10 名提供者中的每一位(n = 42)接受了 6 个月的每周一次的小组电话咨询。所有提供者在培训前、培训后以及培训后 3 个月和 6 个月都接受了评估。比较了培训研讨会和培训加 6 个月咨询的结果。
虽然参与者的知识(t = -22.57,p <.001)和对 PE 和 CPT 的舒适度(χ² = 74.00,p <.001)在完成 2 天的培训后立即显著增加,但接受咨询的参与者更有可能实施(χ² = 20.88,p <.001)并完成或接近完成对患者的 PE 或 CPT(χ² = 20.57,p <.001)在培训后的 6 个月内。
尽管存在一些限制,但这些初步数据支持咨询是 PTSD 治疗培训和在社区中实施的一个重要组成部分。