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Divergent experiences of U.S. veterans who did and did not complete trauma-focused therapies for PTSD: A national qualitative study of treatment dropout.
Kehle-Forbes, Shannon M; Ackland, Princess E; Spoont, Michele R; Meis, Laura A; Orazem, Robert J; Lyon, Alexandra; Valenstein-Mah, Helen R; Schnurr, Paula P; Zickmund, Susan L; Foa, Edna B; Chard, Kathleen M; Alpert, Elizabeth; Polusny, Melissa A.
Afiliación
  • Kehle-Forbes SM; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA; Women's Health Sciences Division at VA Boston, National Center for PTSD, 150 S Huntington Ave, Boston, MA, 02130, USA; University of Minnesota, Department of Medicine,
  • Ackland PE; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA; University of Minnesota, Department of Medicine, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
  • Spoont MR; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA; University of Minnesota, Department of Medicine, 420 Delaware St SE, Minneapolis, MN, 55455, USA; National Center for PTSD, Pacific Islands Division, 459 Patterson Rd,
  • Meis LA; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA; University of Minnesota, Department of Medicine, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
  • Orazem RJ; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA.
  • Lyon A; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA.
  • Valenstein-Mah HR; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA.
  • Schnurr PP; National Center for PTSD, Department of Veterans Affairs, 163 Veterans Dr, White River Junction, VT, 05009, USA; Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Rd, Hanover, NH, 03755, USA.
  • Zickmund SL; Informatics, Decision-Enhancement & Analytic Sciences Center, Salt Lake City VA, 500 S Foothill Blvd, Salt Lake City, UT, 84108, USA.
  • Foa EB; Department of Psychiatry, University of Pennsylvania, 6th Gateway, 3535 Market St, Philadelphia, PA, 19104, USA.
  • Chard KM; Cincinnati VA Medical Center, 3200 Vine St, Cincinnati, OH, 45220, USA.
  • Alpert E; Women's Health Sciences Division at VA Boston, National Center for PTSD, 150 S Huntington Ave, Boston, MA, 02130, USA.
  • Polusny MA; Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, One Veterans Drive, Minneapolis, MN, 55417, USA; University of Minnesota, Department of Psychiatry, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
Behav Res Ther ; 154: 104123, 2022 07.
Article en En | MEDLINE | ID: mdl-35644083
Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) are first-line treatments for posttraumatic stress disorder (PTSD) and have been disseminated throughout the U.S. Veterans Health Administration. Treatment non-completion is common and lessens clinical effectiveness; however, prior work has failed to identify factors consistently associated with non-completion. Semi-structured interviews were conducted with a national sample of veterans who recently completed (n = 60) or did not complete (n = 66) PE or CPT. Non-completer interviews focused on factors that contributed to veterans' decisions to drop out and efforts undertaken to complete PE/CPT. Completer interviews focused on challenges faced in completing treatment and facilitators of completion. Transcripts were coded using a mixed deductive/inductive approach; constant comparison was used to identify differences between completers and non-completers. Completers and non-completers differed in the extent of treatment-specific therapist support received, therapists' flexibility in treatment delivery, the type of encouragement offered by the care team and social supports, their interpretation of symptom worsening, the perceived impact of treatment on functioning, and the impact of stressors on their treatment engagement. Treatment-specific therapist support, more patient-centered and flexible treatment delivery, leveraging the full care team, and addressing functional concerns are potential targets for PE and CPT engagement interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Veteranos / Terapia Cognitivo-Conductual / Terapia Implosiva Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Humans Idioma: En Revista: Behav Res Ther Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos por Estrés Postraumático / Veteranos / Terapia Cognitivo-Conductual / Terapia Implosiva Tipo de estudio: Prognostic_studies / Qualitative_research Límite: Humans Idioma: En Revista: Behav Res Ther Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido