Integrative Interventions

In addition to the core of prolonged exposure in the Prolonged Exposure-Intensive Outpatient Program (PE-IOP), the program also includes integrative interventions designed to encourage positive coping, wellness, and maintenance of gains from PE-IOP. These integrative interventions can vary based on availability, cost, patient population, etc. While they can vary, program implementers should be cautious that the chosen interventions have a general rationale that fits the overall PE-IOP milieu by supporting approaching and not avoiding trauma memories and reminders and that emotions are not dangerous but a normal part of life. The authors discuss the rationale for inclusion of interactive interventions as well as how to decide what interventions to use.

Variations and How to Decide

Prolonged Exposure for PTSD in Intensive Outpatient Programs (PE-IOP) ◽

10.1093/med-psych/9780190081928.003.0008 ◽

2020 ◽

pp. 115-122

Author(s):

Sheila A. M. Rauch ◽

Barbara O. Rothbaum ◽

Erin R. Smith ◽

Edna B. Foa

Keyword(s):

Program Design ◽

Prolonged Exposure ◽

Imaginal Exposure ◽

Outpatient Program ◽

This therapist guide presents the scaffold and structure for the Prolonged Exposure-Intensive Outpatient Program (PE-IOP). The program is focused on exposure as provided through individual imaginal exposure and group in vivo exposure. The format presented is based primarily on the model used in the Emory Healthcare Veterans Program (EHVP), but this chapter provides a focus on the most common variations in program design with a discussion of how to decide between the different potential variations. Relevant inclusions and exclusions are presented along with rationales.

Intensive Outpatient Program Using Prolonged Exposure for Combat-Related PTSD: A Case Study

Cognitive and Behavioral Practice ◽

10.1016/j.cbpra.2021.06.001 ◽

2021 ◽

Author(s):

Casey L. Straud ◽

Tabatha H. Blount ◽

Carmen P. McLean ◽

Cindy A. McGeary ◽

Lauren M. Koch ◽

...

Keyword(s):

Prolonged Exposure ◽

Outpatient Program ◽

Daily Session Schedule

Prolonged Exposure for PTSD in Intensive Outpatient Programs (PE-IOP) ◽

10.1093/med-psych/9780190081928.003.0007 ◽

2020 ◽

pp. 101-114

Author(s):

Sheila A. M. Rauch ◽

Barbara O. Rothbaum ◽

Erin R. Smith ◽

Edna B. Foa

Keyword(s):

Prolonged Exposure ◽

Daily Session ◽

Improve Efficiency ◽

Outpatient Program ◽

This chapter presents how all the pieces of the Prolonged Exposure-Intensive Outpatient Program (PE-IOP) fit together to form a program. The authors discuss areas for variations and ways to improve efficiency. Each day of the PE-IOP program is described, with each component noted and the detailed specifics outlined. Suggested time markers for sessions are presented.

Vestibular Test Patterns in the NICoE Intensive Outpatient Program Patient Population

Military Medicine ◽

10.1093/milmed/usx170 ◽

2018 ◽

Vol 183 (suppl_1) ◽

pp. 237-244 ◽

Cited By ~ 3

Author(s):

John E King ◽

Marcy M Pape ◽

Paula N Kodosky

Keyword(s):

Patient Population ◽

Outpatient Program ◽

Foundations of Prolonged Exposure

Prolonged Exposure for PTSD in Intensive Outpatient Programs (PE-IOP) ◽

10.1093/med-psych/9780190081928.003.0001 ◽

2020 ◽

pp. 1-10

Author(s):

Sheila A. M. Rauch ◽

Barbara O. Rothbaum ◽

Erin R. Smith ◽

Edna B. Foa

Keyword(s):

Primary Care ◽

Patient Care ◽

Emotional Processing ◽

Prolonged Exposure ◽

Mechanisms Of Change ◽

Alternative Treatments ◽

Processing Theory ◽

Outpatient Program ◽

This chapter presents the foundations for prolonged exposure (PE) therapy as they have been developed in emotional processing theory to immerse the provider in theory that will guide all decisions during PE, whether they are using the intensive outpatient program (PE-IOP) in this manual or another model (e.g., PE-Primary Care, or standard PE). The authors present a discussion on how PE works and on the research supporting the theorized mechanisms of change. In addition, alternative treatments are described, including medication and considerations for patients who are already on medications when they are engaged in PE-IOP. The chapter ends with a discussion of why this PE-IOP model was developed and when it may be indicated for patient care.

An intensive outpatient program with prolonged exposure for veterans with posttraumatic stress disorder: Retention, predictors, and patterns of change.

Psychological Services ◽

10.1037/ser0000422 ◽

2020 ◽

Cited By ~ 2

Author(s):

Sheila A. M. Rauch ◽

Carly W. Yasinski ◽

Loren M. Post ◽

Tanja Jovanovic ◽

Seth Norrholm ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Prolonged Exposure ◽

Outpatient Program ◽

Prolonged Exposure for PTSD in Intensive Outpatient Programs (PE-IOP)

10.1093/med-psych/9780190081928.001.0001 ◽

2020 ◽

Author(s):

Sheila A.M. Rauch ◽

Barbara Olasov Rothbaum ◽

Erin R. Smith ◽

Edna B. Foa

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Patient Population ◽

Stress Disorder ◽

Prolonged Exposure ◽

Traumatic Experiences ◽

Model Of Care ◽

Intrusive Memories ◽

Outpatient Program ◽

Trauma can leave a lasting impact on survivors. Some survivors are haunted by intrusive memories; avoid people, places, and situations related to the trauma; and feel constantly on edge due to posttraumatic stress disorder (PTSD) and related posttrauma reactions. Effective treatment can help survivors suffering with PTSD to process the trauma and no longer feel haunted by traumatic experiences from their past. Prolonged exposure (PE) therapy is a highly effective, flexible, individualized psychotherapy that reduces the symptoms of PTSD. PE is the most widely studied treatment for PTSD, with more than 100 studies showing its efficacy and effectiveness in PTSD and comorbid patient populations affected by single-incident and multiple-incident traumas of all types (e.g., combat, sexual assault, etc.). This manual presents a PE protocol for use in residential and massed programs to provide an innovative new model of care that provides excellent retention and transformational symptom outcomes. Providers are presented with the elements of the PE protocol along with all the logistics for how to provide PE in an intensive outpatient program. Variations and considerations for implementation are presented to allow providers designing programs to consider what best fits their patient population and setting. Patient and provider forms are included for use.

Exposure in PE-IOP

Prolonged Exposure for PTSD in Intensive Outpatient Programs (PE-IOP) ◽

10.1093/med-psych/9780190081928.003.0004 ◽

2020 ◽

pp. 47-88

Author(s):

Sheila A. M. Rauch ◽

Barbara O. Rothbaum ◽

Erin R. Smith ◽

Edna B. Foa

Keyword(s):

Emotional Processing ◽

Prolonged Exposure ◽

Imaginal Exposure ◽

Exposure Session ◽

Outpatient Program ◽

Intensive Outpatient ◽

The Individual

This chapter presents in-depth details of how to implement the exposure component of the Prolonged Exposure-Intensive Outpatient Program (PE-IOP), including places where variation is acceptable and why. The authors present the logistics and rationale for individual sessions that include imaginal exposure and individualized trauma emotional processing. In addition, the authors present in vivo group exposure session logistics and rationale. The in vivo group includes the general psychoeducation components of PE, the in vivo exposure hierarchy creation, and the practice of in vivo exposure. The exposures may occur in a group or individually, escorted or non-escorted, as clinically indicated for the individual patient.