Sticking it out in trauma-focused treatment for PTSD: It takes a village.

Autor:	Meis LA; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Noorbaloochi S; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Hagel Campbell EM; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Erbes CR; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Polusny MA; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Velasquez TL; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Bangerter A; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Cutting A; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System., Eftekhari A; Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System., Rosen CS; Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System., Tuerk PW; Sheila C Johnson Center for Clinical Services, University of Virginia., Burmeister LB; Phoenix VA Health Care System., Spoont MR; Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System.
Jazyk:	angličtina
Zdroj:	Journal of consulting and clinical psychology [J Consult Clin Psychol] 2019 Mar; Vol. 87 (3), pp. 246-256.
DOI:	10.1037/ccp0000386
Abstrakt:	Objective: One in 3 veterans will dropout from trauma-focused treatments for posttraumatic stress disorder (PTSD). Social environments may be particularly important to influencing treatment retention. We examined the role of 2 support system factors in predicting treatment dropout: social control (direct efforts by loved ones to encourage veterans to participate in treatment and face distress) and symptom accommodation (changes in loved ones' behavior to reduce veterans' PTSD-related distress). Method: Veterans and a loved one were surveyed across 4 VA hospitals. All veterans were initiating prolonged exposure therapy or cognitive processing therapy (n = 272 dyads). Dropout was coded through review of VA hospital records. Results: Regression analyses controlled for traditional, individual-focused factors likely to influence treatment dropout. We found that, even after accounting for these factors, veterans who reported their loved ones encouraged them to face distress were twice as likely to remain in PTSD treatment than veterans who denied such encouragement. Conclusions: Clinicians initiating trauma-focused treatments with veterans should routinely assess how open veterans' support systems are to encouraging veterans to face their distress. Outreach to support networks is warranted to ensure loved ones back the underlying philosophy of trauma-focused treatments. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Databáze:	MEDLINE
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