PE is an efficacious treatment for active-duty Army soldiers with PTSD from deployments to Iraq or Afghanistan. Results extend previous evidence supporting the efficacy of PE to active-duty military personnel and raise important questions for future research on VRE. (PsycINFO Database Record

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High treatment dropout rates reported in recent literature have brought into question the effectiveness of trauma‐focused posttraumatic stress disorder (PTSD) treatments among military populations. The aim of the current systematic review was to evaluate PTSD treatment dropout rates among military populations by treatment type and other study‐level variables. We searched four databases as well as gray literature for randomized controlled trials that evaluated evidence‐based PTSD treatments in samples of active duty personnel and/or veterans. In total, 26 studies were included in this review, with a total of 2,984 participants. We analyzed dropout rates across treatment types using multivariate meta‐analysis. Across all forms of treatment, the aggregated dropout rate was 24.2%. Dropout percentages based on treatment type were 27.1% for trauma‐focused treatments, 16.1% for non–trauma‐focused treatments, and 6.8% for waitlist groups. We found substantial heterogeneity between studies that was not explained by military status or other study‐level covariates. Summary risk ratios (RRs) comparing relative dropout between treatment groups indicated that trauma‐focused treatment groups had a higher risk of dropout compared to non–trauma‐focused treatments, RR = 1.60. The statistical heterogeneity of within‐treatment dropout risk ratios was negligible. Dropout rates among military patients receiving trauma‐focused therapies were only slightly higher than those reported in the literature among civilian populations and were not explained by study‐level covariates.

This article describes the development and evaluation of a training program for behavioral health providers on the integration of mobile health applications (health apps) in clinical care. The purpose was to train military and Department of Veterans Affairs (VA) providers in the use and current research of various behavioral health apps. The training focused on 5 core competencies: gaining knowledge on the evidence base for using mobile apps in behavioral health practice, effective integration of mobile technologies into traditional treatment settings, security and privacy issues involved with digital data, ethical issues, and cultural considerations. During a 3-year span (October 2014 -September 2017), the training program delivered 20 one-day workshops at 15 military or VA locations, reaching 760 Department of Defense and VA clinicians (psychologists, social workers, physicians, and nurses) on best practices for health apps in clinical care. Prior to the training, less than half of the providers who attended the workshop (41.1%) reported that they were using health apps during treatment. Just following the training, 93.7% of the trainees indicated their intent to use health apps during patient care. At the 3-month posttraining interval, provider-reported use of health apps in treatment was 90.8%. Results demonstrated the impact of a mobile apps provider training program to deliver a relevant, feasible, and impactful approach to educating providers regarding mobile health best practices. Data collected also provided valuable insight into military provider technology use over a 3-year period. Public Significance StatementIn order for clinicians to leverage mobile health technology to best serve their patients, training on best practices is necessary. This article describes the results of an education and training program that successfully trained 760 clinicians over the course of a 3-year period on best practices for mobile health in clinical care.

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