Behavioral Science Division of the National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA.
Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
Adm Policy Ment Health. 2022 Nov;49(6):1019-1030. doi: 10.1007/s10488-022-01214-1. Epub 2022 Aug 5.
Social support is bidirectionally linked to symptoms of posttraumatic stress disorder (PTSD). Evidence suggests that family involvement in veterans' mental health treatment is desired by both veterans and family members, and that such involvement has the potential to improve treatment outcomes. However, rates of family involvement are low in the Veterans Health Administration (VHA). We sought to understand VHA clinicians' perspectives on family involvement in PTSD treatment by conducting qualitative interviews with 31 providers at 10 VHA facilities across the U.S. The i-PARIHS framework was used to guide the interviews and analysis, and several major themes were identified. All clinicians reported that they at least occasionally offered family-inclusive sessions, and they frequently referenced both the influence of family behaviors or attitudes on veterans' functioning, and also how veterans' symptoms could cause tremendous disruption in the family. Clinicians' past experience with supervised family- or couple-based work strongly influenced their current comfort with family-inclusive sessions. Multiple potential avenues exist to support increased family involvement in PTSD treatment in VHA.
社会支持与创伤后应激障碍（PTSD）症状呈双向关联。有证据表明，退伍军人和家庭成员都希望家属参与退伍军人的心理健康治疗，而且这种参与有可能改善治疗效果。然而，退伍军人事务部（VA）的家属参与率很低。我们通过对美国 10 个 VA 设施的 31 名提供者进行定性访谈，试图了解 VA 临床医生对 PTSD 治疗中家属参与的看法。i-PARIHS 框架用于指导访谈和分析，并确定了几个主要主题。所有临床医生都报告说，他们至少偶尔会提供包含家属的治疗方案，他们经常提到家庭行为或态度对退伍军人功能的影响，以及退伍军人的症状如何给家庭带来巨大的破坏。临床医生过去在监督家庭或夫妻为基础的工作方面的经验，强烈影响了他们目前对包含家属的治疗方案的接受程度。VA 支持增加 PTSD 治疗中家属参与的方式有很多。
