Factors associated with low and high use of psychotherapy in veterans with PTSD.

Abstract

Both low and high utilization of psychotherapy for posttrauamtic stress disorder (PTSD) may be problematic. Low utilization may translate into patients receiving insufficient services to effect clinical change, whereas high utilization may lead to resource depletion as a disproportionate amount of available resources are focused on a small number of patients. This study examined rates and predictors of low and high psychotherapy utilization in a sample of 157 patients enrolled in an outpatient Veterans Affairs (VA) PTSD clinic. Approximately 25% of the sample were low users, receiving fewer than 4 sessions per year, whereas 16% were categorized as high users, receiving 52 or more therapy sessions per year during their course of treatment. Indicators of clinical severity, including comorbidity, global functioning, and number of inpatient admissions, were not associated with low versus high utilization. Age was the only clinical or demographic variable that independently predicted utilization, with older veterans using more services. Qualitative data indicated that social and relational factors, such as lack of social support, may contribute to utilization rates in veterans with PTSD.

Heterogeneity of Mental Health Service Utilization and High Mental Health Service Use Among Women Eight Years After Initiating Substance Use Disorder Treatment

“…Currently, there is no consensus on what criteria should be used to define high use of mental health services (Kent et al, 1995; Junghan & Brenner, 2006; Vandyk, Harrison, VenDenkerkhof, Graham, & Ross-White, 2013). Several studies define high use by quantifying how many mental health service episodes occur in a time period ranging from three months to fifteen years (Roick et al, 2004; Pasic et al, 2005; Chaput & Lebel, 2007; Broadbent, Kydd, Sanders, & Vanderpyl, 2008; Morlino et al, 2011; Lindamer et al, 2012; Graca et al, 2013; Hundt et al, 2014; Vandyk et al, 2014). Others have determined who is a high user by using formulas that calculate which individuals account for a disproportionate number of mental health episodes or total days of service compared to the total population of mental health service utilizers (Harrison-Read et al, 2002; Junghan & Brenner, 2006; Vandyk et al, 2013).…”

Evaluation of an internet-based intervention for service members of the German armed forces with deployment-related posttraumatic stress symptoms

“…Moreover, between 60 and 75% of veterans with PTSD do not seek treatment [29][30][31][32][33], and among those who do, the number of attended sessions is usually low. Studies indicate that only 2-10% of veterans suffering from PTSD complete the treatment as intended [30,34].…”

Traumatology Trends: A Content Analysis of Three Counseling Journals From 1994 to 2014

“…The expanded intensity, rate, and duration of deployments to Iraq and Afghanistan have resulted in a significant rise in the number of trauma‐related diagnoses among military personnel (Hines, Sundin, Rona, Wessely, & Fear, ; Mac Donald et al, ), and neuroimaging has revealed measurable changes in brain structure and functioning in combat veterans in the aftermath of traumatic stress (Kuo, Kaloupek, & Woodward, ). Only 34% to 36% of veterans with posttraumatic stress disorder (PTSD) received treatment in the year after their diagnosis, and those who received psychotherapy often received an inadequate number of sessions (Cully et al, ; Hundt et al, ; Mott, Hundt, Sansgiry, Mignogna, & Cully, ). Hundt et al () concluded, “This underutilization is problematic because PTSD is associated with suicide risk, physical disability, reduced quality of life, and employment and relationship difficulties” (p. 731).…”

“…Only 34% to 36% of veterans with posttraumatic stress disorder (PTSD) received treatment in the year after their diagnosis, and those who received psychotherapy often received an inadequate number of sessions (Cully et al, ; Hundt et al, ; Mott, Hundt, Sansgiry, Mignogna, & Cully, ). Hundt et al () concluded, “This underutilization is problematic because PTSD is associated with suicide risk, physical disability, reduced quality of life, and employment and relationship difficulties” (p. 731). In the general population, veterans were twice as likely to die by suicide than nonveterans and were 58 times more likely than nonveterans to use firearms as the method (Kaplan, Huguet, McFarland, & Newsome, ).…”