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退役军人事务部创伤后应激障碍强化门诊治疗方案的可行性。

Feasibility of an intensive outpatient treatment program for posttraumatic stress disorder within the veterans health care administration.

机构信息

VA National Center for Posttraumatic Stress Disorder.

Veterans Affairs Northeast Ohio Healthcare System.

出版信息

Psychol Serv. 2023 Aug;20(3):506-515. doi: 10.1037/ser0000628. Epub 2022 Mar 7.

DOI:10.1037/ser0000628
PMID:35254845
Abstract

Trauma-focused treatments for posttraumatic stress disorder (PTSD), such as Prolonged Exposure (PE) therapy and Cognitive Processing Therapy (CPT), are effective and supported by various Clinical Practice Guidelines; however, drop-out rates for the treatments are as high as 40% within clinical programs. One promising solution is delivering the evidence-based psychotherapies (EBPs) three or more times per week within an intensive outpatient program (IOP) for PTSD. The present study examined the feasibility and effectiveness of a relatively low-resourced PTSD IOP within a larger PTSD program at the Veterans Healthcare Administration. The intensive program offers two tracks (2 week or 4 week) grounded in the massed delivery of PE and CPT. Over a 12-month period, 351 veterans completed an assessment for PTSD and 172 started within one of the local PTSD programs (e.g., weekly, IOP, or residential). Results of the study demonstrated that the IOP is an acceptable (i.e., 87.3% completion rate) and effective (e.g., PTSD Checklist for Diagnostic and Statistical Manual [DSM-5] [PCL-5] decrease effect size = 1.80) treatment option. There was also adequate demand for the program (e.g., 37.2% of patients engaged in care with the PTSD programs started the IOP), and the program was implemented with fidelity to the design. Taken together, the results of this study demonstrate that this low-resource IOP model is a promising approach to improve completion rates within the continuum of care for the treatment of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

创伤聚焦治疗创伤后应激障碍(PTSD),如延长暴露(PE)治疗和认知加工治疗(CPT),是有效的,并得到各种临床实践指南的支持;然而,在临床项目中,治疗的辍学率高达 40%。一个有希望的解决方案是在创伤后应激障碍强化门诊计划(IOP)中每周提供三次或更多次基于证据的心理治疗(EBPs)。本研究在退伍军人医疗保健管理局的更大 PTSD 项目中检查了相对资源较少的 PTSD IOP 的可行性和有效性。强化计划提供了两种基于密集提供 PE 和 CPT 的轨道(2 周或 4 周)。在 12 个月的时间里,351 名退伍军人完成了 PTSD 评估,172 名退伍军人开始参加当地 PTSD 项目之一(例如,每周、IOP 或住院)。研究结果表明,IOP 是一种可接受的(即完成率为 87.3%)和有效的(例如,用于诊断和统计手册 [DSM-5] 的 PTSD 检查表 [PCL-5] 减少效应大小 = 1.80)治疗选择。该计划也有足够的需求(例如,37.2%接受 PTSD 项目治疗的患者开始接受 IOP),并且该计划按照设计的要求得到了执行。总的来说,这项研究的结果表明,这种低资源 IOP 模式是改善 PTSD 连续护理治疗完成率的有前途的方法。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

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引用本文的文献

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Accelerated Prolonged Exposure Therapy for Posttraumatic Stress Disorder in a Veterans Health Administration System.退伍军人健康管理系统中创伤后应激障碍的加速延长暴露疗法
Fed Pract. 2025 Apr;42(Suppl 1):S6-S11. doi: 10.12788/fp.0568. Epub 2025 Apr 2.
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Implementation of a Dedicated Intake Team Reduces Time to Massed PTSD Treatment.实施专门的接诊团队可缩短至集体创伤后应激障碍治疗的时间。
J Behav Health Serv Res. 2025 Apr;52(2):342-356. doi: 10.1007/s11414-024-09920-4. Epub 2024 Dec 17.
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Widening the scope of intensive treatment for PTSD in the military health system.
扩大军事卫生系统中创伤后应激障碍强化治疗的范围。
Mil Psychol. 2024 Nov;36(6):631-636. doi: 10.1080/08995605.2023.2249798. Epub 2023 Aug 25.
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Support for Policy Changes for Therapy Related to Homefront Missions.对与本土任务相关治疗政策变化的支持。
Fed Pract. 2022 Oct;39(10):400-402. doi: 10.12788/fp.0324. Epub 2022 Oct 14.