Accelerated Prolonged Exposure Therapy for Posttraumatic Stress Disorder in a Veterans Health Administration System.

Abstract

Background: Prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) is an evidence-based psychotherapy (EBP) supported by multiple clinical practice guidelines. This article describes an innovative program delivering EBP PE therapy for veterans with PTSD.

Observations: The Intensive Virtual EBP Team (iVET) for PTSD was developed and implemented at the Veterans Affairs Pacific Islands Health Care System. iVET for PTSD is a 3-week telehealth program with 3 main components: (1) massed PE therapy for PTSD (4 sessions per week); (2) whole health and wellness classes (4 group sessions per week); and (3) individual health coaching to address personal wellness goals (1 session per week). In the initial 2.5 years of operation, the program had an 81% retention rate. Patients who participated in iVET for PTSD experienced significantly reduced PTSD, depression, anxiety, and substance use; improved quality of life; and reported high satisfaction with mental health care services. iVET for PTSD mental health care practitioners had increased compassion satisfaction and perceived support, and reduced burnout, secondary traumatic stress, and moral distress over the initial 6 months of providing massed PE in iVET.

Conclusions: Virtual massed PE therapy for a diverse veteran population with PTSD is feasible, acceptable, and effective, with high retention rates and patients reporting high satisfaction with mental health services. In addition, delivering PE for PTSD in a massed format is feasible and acceptable among staff and appears to contribute to improved job satisfaction and professional quality of life.