Qualitative Examination of the Feasibility, Acceptability, and Considerations for Implementation of Massed Evidence-Based Psychotherapies for PTSD Into Outpatient Clinics

Abstract

Massed evidence-based psychotherapies (mEBPs) for posttraumatic stress disorder (PTSD) allow patients to receive effective PTSD treatment in a fraction of the time as weekly EBPs. To date, mEBPs have generally been provided in intensive outpatient or residential clinical settings with additional treatment components and demands. New research suggests that standalone outpatient mEBPs without additional components have several benefits over these programs. To facilitate the expansion of mEBPs into outpatient clinics, barriers and facilitators of implementation must be understood. The current study surveyed and interviewed providers from a VA outpatient clinic that has provided standalone mEBPs for PTSD since 2018. Providers without experience with mEBPs that create treatment plans through shared decision making (n = 8) were surveyed about their beliefs of patient, logistical, and competency factors, as well as buy-into the rationale and preferences regarding mEBPs. Experienced mEBP providers (n = 3) were interviewed about the acceptability, implementation, and practicality of mEBPs in their outpatient clinic. Systematic thematic analysis was used to identify patterns and craft recommendations. Insights from this mixed-methods study were integrated to identify barriers and facilitators to mEBP implementation in an outpatient setting. Recommendations and considerations for new mEBP for PTSD outpatient programs are presented.