Provider perceptions of their patients' dropout from trauma-focused therapy for PTSD in the U.S. Veterans Health Administration.

Autor:	Valenstein-Mah H; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School., Polusny MA; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School., Spoont M; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School., Ackland PE; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System., Meis L; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System., Orazem RJ; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System., Schnurr PP; Executive Division, National Center for PTSD., Zickmund S; IDEAS Center of Innovation, VA Salt Lake City Health Care System., Chard K; Cincinnati VA Medical Center., Kehle-Forbes SM; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System.
Jazyk:	angličtina
Zdroj:	Psychological trauma : theory, research, practice and policy [Psychol Trauma] 2023 Nov; Vol. 15 (8), pp. 1393-1397. Date of Electronic Publication: 2022 Dec 01.
DOI:	10.1037/tra0001399
Abstrakt:	Objective: Many patients who initiate prolonged exposure (PE) and cognitive processing therapy (CPT) do not complete a full course, although little is known about how providers view PE and CPT dropout among their own patients. Method: Semistructured interviews were conducted with providers ( n = 29) in the Veterans Health Administration to understand each provider's experience of dropout by a specific patient whom they treated using PE or CPT. Content analysis was used to categorize perceptions of dropout as negative, somewhat negative, or not negative. Themes associated with somewhat or not negative views of dropout were identified via inductive coding. Results: Fourteen percent of providers viewed their patient's dropout from PE or CPT as wholly negative, 38% as somewhat negative, and 48% as not a negative outcome. Themes associated with viewing dropout as something other than wholly negative included belief that the patient would not benefit from treatment if they were not ready, the importance of maintaining the therapeutic relationship, the view that trauma-focused therapy was not what the patient needed or that the patient could benefit from other approaches, the impression that the patient had made some gains, and that patients are responsible for treatment engagement and have the right to disengage. Conclusions: Providers' perceptions of dropout from PE or CPT for individual patients were rarely viewed as entirely negative. Research is needed to help providers determine when patient dropout is an undesirable outcome and when efforts to reengage patients in trauma-focused treatment are warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Databáze:	MEDLINE
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