Assessing Barriers to Care and Readiness for Cognitive Behavioral Therapy in Early Acute Care PTSD Interventions
| Autor: | Joan Russo, Douglas F. Zatzick, Amy W. Wagner, Sarah Geiss Trusz, Jeff Love |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Cognitive Behavioral Therapy medicine.medical_treatment Psychological intervention MEDLINE Alcohol abuse Patient Acceptance of Health Care medicine.disease behavioral disciplines and activities Mental health Health Services Accessibility Stress Disorders Post-Traumatic Cognitive behavioral therapy Psychiatry and Mental health Treatment Outcome Sobriety Acute care mental disorders medicine Cognitive therapy Humans Psychology Psychiatry Clinical psychology |
| Zdroj: | Psychiatry: Interpersonal and Biological Processes. 74:207-223 |
| ISSN: | 0033-2747 |
| DOI: | 10.1521/psyc.2011.74.3.207 |
| Popis: | Cognitive Behavioral Therapy (CBT) interventions are efficacious in reducing posttraumatic stress disorder (PTSD) but are challenging to implement in acute care and other non-specialty mental health settings. This investigation identified barriers impacting CBT delivery through a content analysis of interventionist chart notes from an acute care PTSD prevention trial. Only 8.5% of all intervention patients were able to complete CBT. Lack of engagement, clinical and logistical barriers had the greatest impact on CBT entry. Treatment preferences and stigma only prevented entry when more primary barriers resolved. Patients with prior diagnosis of alcohol abuse or dependence were able to enter CBT after six months of sobriety. Based on the first trial, we developed a CBT readiness assessment tool. We implemented and evaluated the tool in a second early intervention trial. Lack of engagement emerged again as the primary impediment to CBT entry. Patients who were willing to enter CBT treatment but demonstrated high rates of past trauma or diagnosis of PTSD were also the least likely to engage in any PTSD treatment one month post-discharge. Findings support the need for additional investigations into engagement and alternative delivery strategies, including those which dismantle traditional office-based, multi-session CBT into stepped, deliverable components. |
| Databáze: | OpenAIRE |
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