Pretreatment stabilization increases completion of trauma-focused evidence-based psychotherapies.

IF 1.4 4区 农林科学 Q4 SOIL SCIENCE
Eurasian Soil Science Pub Date : 2024-12-01 Epub Date: 2022-05-05 DOI:10.1037/tra0001196
Anna H Staudenmeyer, Susan Maxwell, Brian Mohlenhoff, Julia Yasser, Martha Schmitz, Thomas Metzler, Shira Maguen, Thomas Neylan, William Wolfe
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引用次数: 0

Abstract

Objective: Veterans with posttraumatic stress disorder (PTSD) initiate and complete cognitive processing therapy (CPT) and prolonged exposure (PE) at low rates within Veterans Health Administration (VHA) despite substantial dissemination and training. This study investigated how trauma-informed, skills-based treatment ("stabilization") administered before CPT and PE was related to initiation and completion of trauma-focused evidence-based psychotherapies (TF-EBPs).

Method: Data were extracted from the VHA electronic medical record to identify veterans who initiated outpatient treatment in the PTSD Clinical Team (PCT) at a Veterans Affairs Health Care System. Treatment initiation was defined as three or more PCT visits with no prior PCT care for at least 18 months (N = 341). Before initiation of TF-EBP, veterans received either no stabilization or received individual and/or group stabilization.

Results: Twenty-eight percent of veterans without stabilization (n = 115) initiated TF-EBP, compared with 34% of veterans who completed individual-only stabilization (n = 82), and 10% of veterans who completed group-only stabilization (n = 29, p = .050). Compared with those with no stabilization, individual stabilization was associated with significantly higher TF-EBP completion (93% vs. 50%, p < .001). CPT completion was also significantly higher for veterans who received individual-only stabilization (90% vs. 43%, p = .001). Results for PE followed the same relationship, but did not reach significance (100% vs. 67%, p = .090).

Conclusions: Findings suggest that individual stabilization may improve delivery of TF-EBPs in VHA settings by increasing TF-EBP completion without reducing initiation, while pretreatment with group-only stabilization may reduce initiation of TF-EBPs. Results inform how models of care can improve TF-EBP retention and completion among veterans with PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

治疗前的稳定化可提高以创伤为重点的循证心理疗法的完成率。
目的:患有创伤后应激障碍(PTSD)的退伍军人在退伍军人健康管理局(VHA)内开始并完成认知处理疗法(CPT)和长期暴露疗法(PE)的比例很低,尽管进行了大量的宣传和培训。本研究调查了在CPT和PE之前进行的创伤知情技能型治疗("稳定")与启动和完成以创伤为重点的循证心理疗法(TF-EBPs)之间的关系:从退伍军人事务部的电子病历中提取数据,以确定在退伍军人事务部医疗保健系统的创伤后应激障碍临床小组(PCT)中开始门诊治疗的退伍军人。开始治疗的定义是接受过三次或三次以上的 PCT 治疗,且至少在 18 个月内未接受过 PCT 治疗(N = 341)。在开始 TF-EBP 治疗之前,退伍军人要么没有接受稳定治疗,要么接受了个人和/或小组稳定治疗:28%的未接受稳定治疗的退伍军人(n = 115)启动了 TF-EBP,而 34% 的退伍军人只接受了个人稳定治疗(n = 82),10% 的退伍军人只接受了小组稳定治疗(n = 29,p = .050)。与未完成稳定化治疗的退伍军人相比,个人稳定化治疗的退伍军人完成 TF-EBP 的比例明显更高(93% 对 50%,p < .001)。仅接受个人稳定化治疗的退伍军人的 CPT 完成率也明显更高(90% 对 43%,P = .001)。PE的结果与此关系相同,但没有达到显著性(100% vs. 67%,p = .090):研究结果表明,个人稳定化治疗可提高 TF-EBP 的完成率,而不会降低 TF-EBP 的启动率,从而改善退伍军人医疗服务机构中 TF-EBP 的实施情况,而只进行小组稳定化治疗的预处理可能会降低 TF-EBP 的启动率。研究结果为如何改善创伤后应激障碍退伍军人的TF-EBP保留率和完成率提供了参考。(PsycInfo Database Record (c) 2022 APA,保留所有权利)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Eurasian Soil Science
Eurasian Soil Science 农林科学-土壤科学
CiteScore
2.70
自引率
35.70%
发文量
137
审稿时长
12-24 weeks
期刊介绍: Eurasian Soil Science publishes original research papers on global and regional studies discussing both theoretical and experimental problems of genesis, geography, physics, chemistry, biology, fertility, management, conservation, and remediation of soils. Special sections are devoted to current news in the life of the International and Russian soil science societies and to the history of soil sciences. Since 2000, the journal Agricultural Chemistry, the English version of the journal of the Russian Academy of Sciences Agrokhimiya, has been merged into the journal Eurasian Soil Science and is no longer published as a separate title.
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