Mental Health Clinician Practices and Perspectives on Treating Adults with Co-Occurring Posttraumatic Stress and Substance Use Disorders.

IF 1.5 4区医学 Q3 PSYCHIATRY

Journal of Dual Diagnosis Pub Date : 2023-10-01 Epub Date: 2023-11-01 DOI:10.1080/15504263.2023.2260338

Anka A Vujanovic, Sudie E Back, Samuel J Leonard, Lyndsey Zoller, Debra L Kaysen, Sonya B Norman, Julianne C Flanagan, Joy M Schmitz, Patricia Resick

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引用次数: 1

Abstract

Objective: Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) commonly co-occur and represent a complex, challenging clinical comorbidity. Meta-analytic studies and systematic reviews suggest that trauma-focused treatments are more efficacious than non-trauma focused interventions for co-occurring PTSD/SUD. However, relatively little is known about mental health clinicians' practices or preferences for treating co-occurring PTSD/SUD. The present study aimed to describe the current clinical practices of mental health clinicians who treat PTSD and/or SUD-related conditions and to assess interest in novel integrative treatments for PTSD/SUD.

Methods: Licensed mental health clinicians (N = 76; M_age = 39.59, SD = 8.14) who treat PTSD and/or SUD completed an anonymous online survey from April 2021 to July 2021.

Results: The majority (61.8%) of clinicians reported using integrative treatments for PTSD/SUD. The most commonly used trauma-focused treatments were 1) Cognitive Processing Therapy (CPT: 71.1%) and 2) Prolonged Exposure Therapy (PE: 68.4%) for PTSD. Approximately half (51.3%) of clinicians endorsed using Relapse Prevention (RP) for SUD. The vast majority (97.4%) of clinicians were somewhat or very interested in a new integrative CPT-RP intervention, and 94.7% of clinicians believed patients would be interested in a CPT-RP intervention. In the absence of an available evidence-based integrative treatment using CPT, 84.0% of clinicians reported modifying extant treatment protocols on their own to address PTSD and SUD concurrently.

Conclusions: The findings demonstrate mental health clinician support of integrative treatments for PTSD/SUD. The most commonly used trauma-focused intervention was CPT and clinicians expressed strong interest in an integrative intervention that combines CPT and RP. Implications for future treatment development are discussed.

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心理健康临床医生治疗成人创伤后应激和物质使用障碍的实践和展望。

目的：创伤后应激障碍（PTSD）和物质使用障碍（SUD）通常同时发生，是一种复杂的、具有挑战性的临床共病。荟萃分析研究和系统综述表明，对于同时发生的创伤后应激障碍/SUD，以创伤为重点的治疗比非以创伤为中心的干预更有效。然而，人们对心理健康临床医生治疗同时发生的创伤后应激障碍/SUD的做法或偏好知之甚少。本研究旨在描述治疗创伤后应激障碍和/或SUD相关疾病的心理健康临床医生的当前临床实践，并评估他们对新型综合治疗PTSD/SUD的兴趣。方法：持有执照的心理健康临床医生（N = 76；Mage=39.59，SD = 8.14）治疗创伤后应激障碍和/或SUD的患者于2021年4月至2021年7月完成了一项匿名在线调查。结果：大多数（61.8%）临床医生报告使用综合治疗PTSD/SUD。最常用的以创伤为重点的治疗方法是1）认知处理治疗（CPT:71.1%）和2）PTSD的长期暴露治疗（PE:68.4%）。大约一半（51.3%）的临床医生支持使用复发预防（RP）治疗SUD。绝大多数（97.4%）临床医生对新的综合CPT-RP干预有一定或非常感兴趣，94.7%的临床医生认为患者会对CPT-RP介入感兴趣。在缺乏使用CPT的循证综合治疗的情况下，84.0%的临床医生报告称，他们自己修改了现有的治疗方案，以同时解决PTSD和SUD。结论：研究结果表明心理健康临床医生支持PTSD/SUD的综合治疗。最常用的以创伤为中心的干预措施是CPT，临床医生对结合CPT和RP的综合干预措施表示了浓厚的兴趣。讨论了对未来治疗发展的影响。

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来源期刊

Journal of Dual Diagnosis Multiple-

CiteScore

4.90

自引率

13.60%

发文量

期刊介绍： Journal of Dual Diagnosis is a quarterly, international publication that focuses on the full spectrum of complexities regarding dual diagnosis. The co-occurrence of mental health and substance use disorders, or “dual diagnosis,” is one of the quintessential issues in behavioral health. Why do such high rates of co-occurrence exist? What does it tell us about risk profiles? How do these linked disorders affect people, their families, and the communities in which they live? What are the natural paths to recovery? What specific treatments are most helpful and how can new ones be developed? How can we enhance the implementation of evidence-based practices at clinical, administrative, and policy levels? How can we help clients to learn active recovery skills and adopt needed supports, clinicians to master new interventions, programs to implement effective services, and communities to foster healthy adjustment? The Journal addresses each of these perplexing challenges.