Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC).
Department of Psychiatry and Behavioral Sciences.
Psychol Serv. 2021 Nov;18(4):651-662. doi: 10.1037/ser0000425. Epub 2020 Aug 27.
Posttraumatic stress disorder (PTSD) clinics in the Department of Veterans Affairs (VA) often provide psychoeducational or skill-building groups to prepare veterans for trauma-focused PTSD treatments. However, there has been limited evaluation of the effectiveness of this phase-based approach for treatment engagement and symptom reduction. Participants included 575 veterans seeking treatment for PTSD whose treatment outcomes were assessed in a VA outpatient PTSD clinic staffed by mental health professionals and trainees. Participants completed self-report measures of baseline characteristics and psychiatric symptoms as part of routine PTSD clinic treatment. We tested the association of preparatory group treatment with engagement in and treatment response to subsequent trauma-focused psychotherapies, cognitive processing therapy (CPT) and prolonged exposure therapy (PE), which are designated by VA as evidence-based psychotherapies (EBP). Following participation in preparatory treatments, 94/391 (24%) of veterans engaged in a subsequent trauma-focused EBP (CPT or PE). Relative to patients who had previously completed a preparatory group, patients initiating a trauma-focused EBP without having first attended preparatory PTSD treatment had similar rates of trauma-focused EBP completion and better treatment response, as measured by decreases on the PTSD Checklist for , fifth edition (; PCL-5), (1, 3009) = 10.89, = .001, and Patient Health Questionnaire 9 measure of depressive symptoms (1, 3688) = 6.74, = .010. Overall, veterans reported greater symptom reduction when engaging in trauma-focused EBP directly, without having previously attended a preparatory group. These data support veteran engagement in trauma-focused EBPs for PTSD without first being encouraged to complete psychoeducational or skill-building groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
创伤后应激障碍（PTSD）诊所通常在退伍军人事务部（VA）提供心理教育或技能培养小组，为退伍军人准备创伤为重点的 PTSD 治疗。然而，对于这种基于阶段的方法对治疗参与和症状减轻的有效性评估有限。参与者包括 575 名寻求 PTSD 治疗的退伍军人，他们的治疗结果在由心理健康专业人员和受训人员组成的 VA 门诊 PTSD 诊所进行评估。参与者完成了基线特征和精神症状的自我报告措施，作为 PTSD 诊所常规治疗的一部分。我们测试了预备组治疗与随后的创伤为重点的心理治疗、认知加工治疗（CPT）和延长暴露治疗（PE）的参与和治疗反应之间的关联，VA 将这些治疗方法指定为循证心理治疗（EBP）。参加预备治疗后，94/391（24%）名退伍军人接受了后续的创伤为重点的 EBP（CPT 或 PE）。与之前完成预备小组的患者相比，没有先参加预备 PTSD 治疗而开始创伤为重点的 EBP 的患者，创伤为重点的 EBP 完成率和治疗反应更好，以 PTSD 检查表第五版（PCL-5）的减少来衡量（1,3009）=10.89, =.001，以及患者健康问卷 9 项抑郁症状测量（1,3688）=6.74, =.010。总体而言，当直接参与创伤为重点的 EBP 时，退伍军人报告的症状减轻更大，而无需先参加预备小组。这些数据支持退伍军人在 PTSD 方面参与创伤为重点的 EBP，而无需首先被鼓励完成心理教育或技能培养小组。（PsycInfo 数据库记录（c）2021 APA，保留所有权利）。
