Treatment choice among veterans with PTSD symptoms and substance-related problems: Examining the role of preparatory treatments in trauma-focused therapy
| Autor: | Laura D. Wiedeman, Kelly P. Maieritsch, Cendrine Robinson, Gregory Bartoszek, Susan M. Hannan |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Substance-Related Disorders MEDLINE Comorbidity PsycINFO Psychological Trauma Severity of Illness Index Stress Disorders Post-Traumatic 03 medical and health sciences 0302 clinical medicine Behavior Therapy medicine Humans Initial treatment Veterans Affairs Applied Psychology Depression (differential diagnoses) Aged Veterans Treatment choices business.industry Patient Preference Middle Aged medicine.disease United States 030227 psychiatry Substance abuse United States Department of Veterans Affairs Clinical Psychology Outcome and Process Assessment Health Care Ptsd treatment Psychotherapy Group Female business Clinical psychology |
| Zdroj: | Psychological Services. 17:405-413 |
| ISSN: | 1939-148X 1541-1559 |
| Popis: | Although common practice in Veterans Affairs (VA) PTSD clinics, it is unclear whether preparatory treatment improves trauma-focused treatment (TFT) completion and outcomes. Furthermore, little is known about whether treatment-seeking veterans in naturalistic settings would chose to prioritize preparatory treatment if given the option of a phase-based approach or direct access to TFT, and how substance-related problems (SRPs) influence this treatment choice. The first aim of this study was to explore how co-occurring SRPs (ranging from none to moderate/severe) influence PTSD treatment choices in a naturalistic setting where veterans were offered a choice between a phase-based approach (i.e., preparatory treatment) or direct access to TFT. The study also examined whether initial treatment choice and severity of co-occurring SRPs influenced TFT completion and outcomes. The second aim was to investigate whether preparatory treatment led to superior TFT completion or outcomes, irrespective of co-occurring SRPs. Analyses were conducted using archival data from 737 United States veterans referred for outpatient VA PTSD treatment. SRPs did not predict initial treatment choice or the length of preparatory group participation. Neither SRPs nor preparatory group participation predicted TFT completion or outcomes (measured as change in PTSD and depression symptoms from pre- to post-TFT). Preparatory group participation did not predict improved TFT completion or outcomes, irrespective of co-occurring SRPs. These findings suggest that veterans with PTSD symptoms and co-occurring SRPs may make similar treatment choices and benefit from either a phase-based approach or direct TFT initiation, and preparatory treatments may not increase patient readiness for veterans seeking TFT. (PsycInfo Database Record (c) 2020 APA, all rights reserved). |
| Databáze: | OpenAIRE |
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