Integrating care for chronic pain and PTSD: A qualitative exploration of staff and patient perspectives.

Abstract

Despite the advantages of integrated care for co-occurring chronic pain and posttraumatic stress disorder (CP + PTSD), barriers impede its implementation. In this qualitative study, we examined facilitators and barriers of integrated care for CP + PTSD at a single Veterans Affairs medical center. We used purposive sampling and snowball recruitment to identify key stakeholders. We conducted semistructured interviews (N = 38) via video teleconferencing between January and May of 2022. We analyzed interview data employing both thematic and matrixed analysis methodologies. We interviewed VA staff (providers [n = 11], clinic managers [n = 5], and administrators [n = 2]) and patients with CP + PTSD (n = 19). There were three main findings: (a) current models disconnect care for CP + PTSD and fail in fully addressing the intricacies of this comorbidity, (b) the interconnection of CP + PTSD symptoms supports the need to overcome barriers to integrated treatment, and (c) facility- and system-level barriers to implementation of integrated care include staffing and having an evidence-based protocol. Staff and patient stakeholders recognized growing momentum supporting the development of integrated, nonpharmacological treatments for CP + PTSD. However, interventions to address barriers are needed to increase wider adoption and implementation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).