Development of a brief primary care intervention for PTSD in adolescents.

Abstract

Objective: Our study aims to adapt an evidence-based, brief intervention for use in an urban safety-net adolescent primary care center with an existing integrated behavioral health team who have not previously treated post-traumatic stress disorder (PTSD) explicitly in the clinic.Background: PTSD is routinely undertreated in adolescent primary care due in part to a lack of evidence-based interventions for PTSD that can be feasibly delivered in primary care. Sustainable PTSD interventions in adolescent medicine clinics must overcome patient, provider, and system-level barriers. Methods:The Brief Relaxation, Education And Trauma Healing (BREATHE) was selected for adaptation based on a literature review of evidence-based target interventions. Purposeful sampling was used to recruit nine adolescent patients, two parents, and eight clinic staff (N=19) for individual qualitative interviews focused on feasibility of implementation of a PTSD intervention delivered in an adolescent medicine primary care clinic that serves diverse patients with high trauma exposure. Audio recordings from these interviews were transcribed and analyzed using inductive and directed a priori approaches related to the central research questions.Results: Participants provided feedback on the format and content of the BREATHE intervention to adapt the existing treatment to be feasible and sustainable in a primary care setting. Overall, participants thought the intervention was helpful and feasible and provided specific feedback for adaptation. Conclusion:This study developed the Primary Care Intervention for PTSD (PCIP) as a resource for improving PTSD care for adolescents in a primary care setting. Further studies will evaluate PCIP efficacy on PTSD symptomology.

“Being who I am means everything bad can happen”: Chronic structural stressors in trauma focused therapy sessions with marginalized adolescents.

“…Participants were recruited as part of a pragmatic feasibility trial of the Primary Care Intervention for PTSD (PCIP): a novel, short-term treatment for adolescent PTSD to be delivered in primary care with existing clinic staff (Ng et al, 2023; Srivastava et al, 2021). The PCIP is delivered in three therapy sessions and targets several mechanisms to reduce PTSD symptoms, including psychoeducation, breathing retraining, and coping skills (Srivastava et al, 2021).…”

“…Participants were recruited as part of a pragmatic feasibility trial of the Primary Care Intervention for PTSD (PCIP): a novel, short-term treatment for adolescent PTSD to be delivered in primary care with existing clinic staff (Ng et al, 2023; Srivastava et al, 2021). The PCIP is delivered in three therapy sessions and targets several mechanisms to reduce PTSD symptoms, including psychoeducation, breathing retraining, and coping skills (Srivastava et al, 2021). The intervention was delivered in Boston Medical Center (BMC), a large safety net hospital that primarily serves minority-status individuals, with 72% of clients insured by publicly funded insurance, such as Medicaid (Ng et al, 2023; Srivastava et al, 2021).…”

“…The PCIP is delivered in three therapy sessions and targets several mechanisms to reduce PTSD symptoms, including psychoeducation, breathing retraining, and coping skills (Srivastava et al, 2021). The intervention was delivered in Boston Medical Center (BMC), a large safety net hospital that primarily serves minority-status individuals, with 72% of clients insured by publicly funded insurance, such as Medicaid (Ng et al, 2023; Srivastava et al, 2021).…”