Service Utilization Following Participation in Cognitive Processing Therapy or Prolonged Exposure Therapy for Post-Traumatic Stress Disorder

Meyers, Laura L.; Strom, Thad Q.; Leskela, Jennie; Thuras, Paul; Kehle‐Forbes, Shannon M.; Curry, Kyle T.

doi:10.7205/milmed-d-12-00302

Cited by 29 publications

(25 citation statements)

References 20 publications

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“…Similarly, researchers at the Minneapolis VA noted a decrease in individual and group therapy after veterans had received treatment for PTSD, amounting to a 39.4% decrease in cost associated with mental health care (Meyers et al, 2013). Veterans with dually diagnosed PTSD and substance use disorder should thus be connected with services that utilize evidence-based PTSD treatment protocols.…”

Section: Discussionmentioning

confidence: 93%

PTSD and Substance Use Disorder Among Veterans: Characteristics, Service Utilization and Pharmacotherapy

Bowe

Rosenheck

2014

Journal of Dual Diagnosis

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Section: Discussionmentioning

confidence: 93%

PTSD and Substance Use Disorder Among Veterans: Characteristics, Service Utilization and Pharmacotherapy

Bowe

Rosenheck

2014

Journal of Dual Diagnosis

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“…Other studies have reported that Veterans who receive treatment with multiple interventions for PTSD and other trauma-related problems showed significant reductions in suicidal ideation, in addition to other benefits of treatment (Brown et al, 2016;Trockel et al, 2015;Walser et al, 2015). At the system level, VA researchers have documented mental health service and other cost offsets in the range of 30-40 percent associated with the delivery of EBTs for PTSD by trained therapists (Meyers et al, 2013;Tuerk et al, 2013).…”

Section: Veterans Health Administration Ebt Training Programmentioning

confidence: 99%

Evidence-based training in the era of evidence-based practice: Challenges and opportunities for training of PTSD providers

Rosen

Ruzek

Karlin

2017

Behaviour Research and Therapy

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There is a pressing global need for trained and competent mental health clinicians to deliver evidence-based psychological therapies to millions of trauma survivors in need of care. Three model, large-scale training programs were initiated a decade ago, one in the United Kingdom (U.K.), and two in the United States (U.S.), to disseminate high-quality, evidence-based psychological care to traumatized children and adults in need of assistance. Milestone contributions to implementation science have been made by each of these training programs, although limitations and challenges remain to be considered. In contrast, culturally adapted and simplified PTSD interventions and therapy training programs have also been developed and tested during the past decade, three of which show particular promise for broader implementation. These simplified but evidence-based interventions have been developed for use by lay counsellors or health technicians with minimal or no prior mental health training. Finally, a growing range of technology-based and technology-assisted training models for PTSD providers have also been developed and disseminated in the past decade. This trend is expected to accelerate as more providers become accustomed to acquiring clinical training in this modality or format, although significant barriers to technology-based training will need to be overcome.

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“…In one recent study, of 351 veterans who initiated EBP for PTSD, one third (n=135) dropped out before treatment completion [36]. Because completion of EBP not only significantly reduces mental health symptoms [37] but also positively impacts physical health and functioning while decreasing PTSD-related health care costs [38,39], enhancing veteran engagement is critical. Indeed, in one study, the original CALM program was not only found to be acceptable to both providers and patients but also resulted in substantial treatment engagement and homework compliance [20].…”

Section: Discussionmentioning

confidence: 99%

Adapting Coordinated Anxiety Learning and Management for Veterans Affairs Community-Based Outpatient Clinics: Iterative Approach

Abraham¹,

Marchant-Miros²,

McCarther³

et al. 2018

JMIR Ment Health

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BackgroundA national priority at the US Department of Veterans Affairs (VA) is to increase the availability and accessibility of evidence-based psychotherapies (EBPs) across all VA medical facilities. Yet many veterans, particularly those who use remote outpatient VA clinics, still do not receive much needed evidence-based treatment. Strategies are needed for supporting mental health providers at rural VA community-based outpatient clinics (CBOCs) as they translate their clinical training to routine practice. The Coordinated Anxiety Learning Management (CALM) program is a computer-delivered program that supports the delivery of cognitive behavioral therapy (CBT) by providers in outpatient settings to patients with depression and anxiety, including posttraumatic stress disorder.ObjectiveThe objectives of our study were to (1) adapt an existing computer-based program to rural VA CBOCs through feedback from key stakeholder focus groups; (2) develop a prototype of the adapted program; and (3) determine the adapted program’s acceptability and feasibility. Mental health stakeholders included VA leaders (n=4) in the implementation of EBPs, VA experts (n=4) in CBT, VA CBOC mental health providers (n=8), and veterans (n=8) diagnosed with a mental health condition treated using the CALM program and receiving treatment in a VA CBOC.MethodsAn iterative approach comprising 3 waves of focus group discussions was used to develop a modified prototype of CALM. Following each wave of focus group discussions, template analysis was used to rapidly communicate stakeholder recommendations and feedback to the design team. The original program was first adapted through a process of data collection, design modification, and product development. Next, a prototype was developed. Finally, the redesigned program was tested for acceptability and feasibility through a live demonstration.ResultsKey stakeholders suggested modifications to the original CALM program that altered its modules’ appearance by incorporating veteran-centric content. These modifications likely have no impact on the integrity of the original CALM program, but have altered its content to reflect better the demographic characteristics and experiences of rural veterans. Feedback from stakeholder groups indicates that changes will help VA patients identify with the program content, potentially enhancing their treatment engagement.ConclusionsThe development model was effective for economically gathering actionable recommendations from stakeholders to adapt a computer-based program, and it can result in the development of an acceptable and feasible computer-delivered intervention. Results have implications for developing computer-based programs targeting behavior change more broadly and enhancing engagement in EBP.

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Service Utilization Following Participation in Cognitive Processing Therapy or Prolonged Exposure Therapy for Post-Traumatic Stress Disorder

Cited by 29 publications

References 20 publications

PTSD and Substance Use Disorder Among Veterans: Characteristics, Service Utilization and Pharmacotherapy

PTSD and Substance Use Disorder Among Veterans: Characteristics, Service Utilization and Pharmacotherapy

Evidence-based training in the era of evidence-based practice: Challenges and opportunities for training of PTSD providers

Adapting Coordinated Anxiety Learning and Management for Veterans Affairs Community-Based Outpatient Clinics: Iterative Approach

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