Dissemination and Implementation of Evidence-Based Interventions for Adults with PTSD

2020 ◽  
Author(s):  
Heidi La Bash ◽  
Shannon Wiltsey Stirman
Keyword(s):  
Cognitive Processing ◽  
Cultural Context ◽  
Prolonged Exposure ◽  
Empirical Support ◽  
The Body ◽  
Cognitive Processing Therapy ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Initial Stage ◽  
Active Implementation

This chapter reviews current efforts to disseminate and implement evidence-based interventions (EBIs) for adult posttraumatic stress disorder (PTSD), like cognitive processing therapy and prolonged exposure. As the body of empirical support for EBIs has been amassed and best practices identified, concerted efforts are being made to integrate EBIs for PTSD into behavioral health organizations. However, implementation is a complex, multi-faceted process, with a range of factors that can benefit or hinder efforts to diffuse an innovation. Working through each stage of implementation, these factors are reviewed from the initial stage of a needs assessment, through the preparation, active implementation, and finally sustained delivery stages. Factors discussed include those related to the broader sociopolitical and cultural context, the organization, the individuals providing and receiving treatment, as well as those specific to the characteristics of the intervention. Strategies to address these barriers and to amplify the effects of factors that facilitate implementation are also discussed. Finally, the chapter discusses future directions and remaining pressing issues for the field.

scholarly journals Assessing Receptivity to Empirically Supported Treatments in Rape Crisis Centers

2017 ◽  
Vol 18 (2) ◽  
pp. 611-629 ◽  
Author(s):  
Tonya Elaine Edmond ◽  
Rachel Voth Schrag
Keyword(s):  
Cognitive Processing ◽  
Service Sector ◽  
Prolonged Exposure ◽  
Cognitive Processing Therapy ◽  
Dissemination And Implementation ◽  
Trauma Symptoms ◽  
Empirically Supported Treatments ◽  
Empirically Supported ◽  
Rape Crisis Center ◽  
Rape Crisis

Survivors of sexual violence are at risk for PTSD, depression, and anxiety. There are several empirically supported treatments (EST) that are effective for addressing these trauma symptoms; however, uptake of these ESTs among Rape Crisis Center (RCC) counselors is low. This research project sought to determine counselors’ attitudes toward evidence-based practices (EBPs); their perceptions of the intervention characteristics of three specific ESTs: Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and Eye Movement Desensitization and Reprocessing Therapy; and differences in attitudes and perceptions based on agency setting (urban/rural) and counselor education. The Consolidated Framework for Advancing Implementation Science (CFIR) was used to construct a web-based survey to send to all RCCs in Texas (n=83) resulting in an overall agency response rate of 72% (n=60) and responses from 76 counselors. Counselors’ attitudes towards EBP and perspectives on specific ESTs suggest that dissemination and implementation efforts are needed within the RCC service sector to advance the uptake of CPT, EMDR and PE.

Cognitive-Behavioral Interventions for Disorders of Extreme Stress

2018 ◽  
pp. 672-688 ◽  
Author(s):  
J. Gayle Beck ◽  
Allison M. Pickover ◽  
Alexandra J. Lipiniski ◽  
Han N. Tran ◽  
Thomas S. Dodson
Keyword(s):  
Cognitive Processing ◽  
Behavioral Interventions ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Acute Stress ◽  
Empirical Support ◽  
Cognitive Behavioral ◽  
Cognitive Processing Therapy ◽  
Extreme Stress ◽  
Behavioral Treatments

In this chapter, we review the current literature on cognitive-behavioral treatments for posttraumatic stress disorder (PTSD) and acute stress disorder (ASD). Particular attention is paid to treatments for PTSD that have strong empirical support, specifically cognitive processing therapy, prolonged exposure, and eye movement desensitization and reprocessing therapy. Cognitive-behavioral treatments for ASD have evolved differently, with greater emphasis on treatment packages; notably, this literature is less well developed and deserving of considerable more study, relative to the PTSD literature. Throughout the chapter, we have addressed areas for future study, as well issues that are currently salient in the treatment of these two conditions.

scholarly journals Drivers of Preference for Evidence-Based PTSD Treatment: A Qualitative Assessment

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 303-310
Author(s):  
Bella Etingen ◽  
Kathleen M Grubbs ◽  
Juliette M Harik
Keyword(s):  
Cognitive Processing ◽  
Mental Health Treatment ◽  
Online Survey ◽  
Prolonged Exposure ◽  
Qualitative Assessment ◽  
Cognitive Processing Therapy ◽  
Stress Inoculation ◽  
Free Text ◽  
Evidence Based ◽  
Ptsd Treatment

ABSTRACT Introduction Mental health treatment utilization among persons with posttraumatic stress disorder (PTSD) tends to be low but may be improved by aligning treatment with patient preferences. Our objective was to characterize the reasons that drive a person’s selection of a specific evidence-based PTSD treatment. Materials and Methods Data were collected using an online survey of adults who screened positive for PTSD. Participants viewed descriptions of five evidence-based PTSD treatments (cognitive processing therapy, prolonged exposure, eye movement desensitization and reprocessing, stress inoculation training, antidepressant medication) and identified their most preferred treatment. Participants then explained why they selected their top choice. These free-text responses (n = 249) were analyzed using thematic coding and constant comparative methods. Results Identified themes included (1) perceived effectiveness, (2) perceived suitability, (3) requirements of participation, (4) familiarity with the modality, (5) perception of the option as ‘better than alternatives,’ (6) perception of the option as ‘not harmful,’ (7) accessibility, and (8) delivery format. Differences in themes were also examined by treatment modality. Conclusions By highlighting which pieces of information may be most important to detail when presenting different treatment options, these results can help guide treatment planning conversations, as well as the development of shared decision-making tools.

Choices in Gamification of Therapy for PTSD

2016 ◽  
pp. 1309-1323
Author(s):  
Dan Thomsen ◽  
Jeffrey M. Rye ◽  
Tammy Ott
Keyword(s):  
Cognitive Processing ◽  
Game Design ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Cognitive Processing Therapy ◽  
Evidence Based ◽  
Post Traumatic Stress ◽  
Small Pilot Study ◽  
Prolonged Exposure Therapy ◽  
Changing Attitudes

Effective treatments for Post Traumatic Stress Disorder (PTSD) already exist in the form of cognitive processing therapy (CPT) and prolonged exposure therapy (PE). However, common symptoms of PTSD, like depression and avoidance, make finding and engaging patients in these treatments difficult. We have designed SAGA, an online game to help veterans suffering from PTSD. SAGA works to illustrate and educate players about effective therapy so they can successfully engage in evidence-based treatment. SAGA allows players to create and repeatedly edit stories to illustrate how exposure therapy works. This chapter presents the game design choices made to motivate and engage players with PTSD and reports the results of a small pilot study. We also present the design of our upcoming clinical trial, which will determine SAGA's effectiveness in changing attitudes toward evidence based PTSD therapy.

Choices in Gamification of Therapy for PTSD

2016 ◽  
pp. 343-357 ◽  
Author(s):  
Dan Thomsen ◽  
Jeffrey M. Rye ◽  
Tammy Ott
Keyword(s):  
Cognitive Processing ◽  
Game Design ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Cognitive Processing Therapy ◽  
Evidence Based ◽  
Post Traumatic Stress ◽  
Small Pilot Study ◽  
Prolonged Exposure Therapy ◽  
Changing Attitudes

Effective treatments for Post Traumatic Stress Disorder (PTSD) already exist in the form of cognitive processing therapy (CPT) and prolonged exposure therapy (PE). However, common symptoms of PTSD, like depression and avoidance, make finding and engaging patients in these treatments difficult. We have designed SAGA, an online game to help veterans suffering from PTSD. SAGA works to illustrate and educate players about effective therapy so they can successfully engage in evidence-based treatment. SAGA allows players to create and repeatedly edit stories to illustrate how exposure therapy works. This chapter presents the game design choices made to motivate and engage players with PTSD and reports the results of a small pilot study. We also present the design of our upcoming clinical trial, which will determine SAGA's effectiveness in changing attitudes toward evidence based PTSD therapy.

scholarly journals Effectiveness and comparative effectiveness of evidence-based psychotherapies for posttraumatic stress disorder in clinical practice

2021 ◽  
pp. 1-10
Author(s):  
Shira Maguen ◽  
Erin Madden ◽  
Nicholas Holder ◽  
Yongmei Li ◽  
Karen H. Seal ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Cognitive Processing ◽  
Comparative Effectiveness ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Patient Treatment ◽  
Cognitive Processing Therapy ◽  
Symptom Improvement ◽  
Evidence Based

Abstract Background While evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) is a first-line treatment, its real-world effectiveness is unknown. We compared cognitive processing therapy (CPT) and prolonged exposure (PE) each to an individual psychotherapy comparator group, and CPT to PE in a large national healthcare system. Methods We utilized effectiveness and comparative effectiveness emulated trials using retrospective cohort data from electronic medical records. Participants were veterans with PTSD initiating mental healthcare (N = 265 566). The primary outcome was PTSD symptoms measured by the PTSD Checklist (PCL) at baseline and 24-week follow-up. Emulated trials were comprised of ‘person-trials,’ representing 112 discrete 24-week periods of care (10/07–6/17) for each patient. Treatment group comparisons were made with generalized linear models, utilizing propensity score matching and inverse probability weights to account for confounding, selection, and non-adherence bias. Results There were 636 CPT person-trials matched to 636 non-EBP person-trials. Completing ⩾8 CPT sessions was associated with a 6.4-point greater improvement on the PCL (95% CI 3.1–10.0). There were 272 PE person-trials matched to 272 non-EBP person-trials. Completing ⩾8 PE sessions was associated with a 9.7-point greater improvement on the PCL (95% CI 5.4–13.8). There were 232 PE person-trials matched to 232 CPT person-trials. Those completing ⩾8 PE sessions had slightly greater, but not statistically significant, improvement on the PCL (8.3-points; 95% CI 5.9–10.6) than those completing ⩾8 CPT sessions (7.0-points; 95% CI 5.5–8.5). Conclusions PTSD symptom improvement was similar and modest for both EBPs. Although EBPs are helpful, research to further improve PTSD care is critical.

Uniformity of evidence-based treatments in practice? Therapist effects in the delivery of cognitive processing therapy for PTSD.

2013 ◽  
Vol 60 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Kevin M. Laska ◽  
Tracey L. Smith ◽  
Andrew P. Wislocki ◽  
Takuya Minami ◽  
Bruce E. Wampold
Keyword(s):  
Cognitive Processing ◽  
Cognitive Processing Therapy ◽  
Evidence Based ◽  
Therapist Effects ◽  
Evidence Based Treatments

Introduction and Overview

2021 ◽  
pp. 1-16
Author(s):  
Frederic N. Busch ◽  
Barbara L. Milrod ◽  
Cory K. Chen ◽  
Meriamne B. Singer
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Cognitive Processing ◽  
Prolonged Exposure ◽  
Psychodynamic Therapy ◽  
Veterans Administration ◽  
Cognitive Processing Therapy ◽  
Persistent Symptoms ◽  
Prolonged Exposure Therapy ◽  
Trauma Processing ◽  
Multiple Traumas

This chapter provides an introduction to efficacious treatments for posttraumatic stress disorder (PTSD). Despite efficacy of these treatments, many patients do not respond to them or experience persistent symptoms. Efficacious psychotherapies for PTSD used at the Veterans Administration (VA), including prolonged exposure therapy and cognitive processing therapy, are described. While these treatments can be helpful, many patients are avoidant of trauma processing and homework. Furthermore, both treatments tend to focus on one central trauma, to which exposure exercises are targeted, whereas most Veterans experience multiple traumas. An overview of the development and framework of trauma-focused psychodynamic psychotherapy (TFPP), a PTSD-symptom focused brief psychodynamic therapy, is presented. A brief background of psychoanalytic and psychodynamic literature and thinking about trauma is provided to further frame the place of TFPP

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