Buckheit Katherine A, Barden Eileen, Shaw Rachael, Possemato Kyle, Mastroleo Nadine R, Rauch Sheila A M
VA Center for Integrated Healthcare, Syracuse VA Medical Center.
VA Center for Integrated Healthcare, Syracuse VA Medical Center and Binghamton University.
Cogn Behav Pract. 2023 Aug;30(3):551-563. doi: 10.1016/j.cbpra.2022.02.020. Epub 2022 Apr 4.
Symptoms of posttraumatic stress disorder (PTSD) and hazardous alcohol use are highly comorbid. Research on integrated interventions to address PTSD symptoms and hazardous alcohol use concurrently has demonstrated efficacy, yet integrated treatments are underutilized. Both patient (e.g., stigma, scheduling/logistics) and clinician (e.g., concern about symptom exacerbation and/or treatment dropout) barriers may impede utilization of integrated interventions among those with comorbid PTSD symptoms and hazardous alcohol use. Primary care behavioral health models (PCBH), in which embedded behavioral health providers deliver treatment to individuals with mild or moderate behavioral health symptoms in primary care, may help address treatment barriers by offering accessible behavioral health interventions in a destigmatizing setting. This paper presents two case examples from a randomized controlled trial testing the efficacy of an integrated intervention for PTSD symptoms and hazardous alcohol use developed for and delivered in primary care. Outcome data and session-by-session content for two participants are included, along with discussion of barriers encountered during the course of treatment. Clinician-suggested strategies for navigating barriers to facilitate utilization of integrated interventions for PTSD symptoms and hazardous alcohol use are also discussed.
创伤后应激障碍（PTSD）症状与危险饮酒行为高度共病。针对同时解决PTSD症状和危险饮酒行为的综合干预措施的研究已证明其有效性，但综合治疗的利用率较低。患者方面的障碍（如耻辱感、日程安排/后勤问题）和临床医生方面的障碍（如担心症状加重和/或治疗中断）可能会阻碍综合干预措施在患有PTSD症状和危险饮酒行为的人群中的应用。初级保健行为健康模式（PCBH），即由嵌入式行为健康提供者为初级保健中患有轻度或中度行为健康症状的个体提供治疗，可能通过在消除耻辱感的环境中提供可及的行为健康干预措施来帮助解决治疗障碍。本文介绍了一项随机对照试验中的两个案例，该试验测试了一种为初级保健开发并在其中实施的针对PTSD症状和危险饮酒行为的综合干预措施的有效性。包括两名参与者的结果数据和逐节内容，以及对治疗过程中遇到的障碍的讨论。还讨论了临床医生建议的应对障碍以促进PTSD症状和危险饮酒行为综合干预措施应用的策略。
