What Is the Impact of Using Evidence-Based Treatments for Posttraumatic Stress Disorder and Depression in Veterans?

2011 ◽  
Author(s):  
Beau Kilmer ◽  
Christine Eibner ◽  
Jeanne Ringel ◽  
Rosalie Pacula
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Evidence Based ◽  
Evidence Based Treatments ◽  
The Impact

scholarly journals Formative Evaluation Prior to Implementation of a Brief Treatment for Posttraumatic Stress Disorder in Primary Care

2021 ◽  
Author(s):  
Sarah E. Valentine ◽  
Cara Fuchs ◽  
Natalya Sarkisova ◽  
Elyse A. Olesinski ◽  
A. Rani Elwy
Keyword(s):  
Primary Care ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Formative Evaluation ◽  
Stress Disorder ◽  
Safety Net ◽  
Successful Implementation ◽  
Evidence Based ◽  
Primary Care Settings ◽  
Evidence Based Treatments

Abstract Background Successful implementation of evidence-based treatments for posttraumatic stress disorder (PTSD) in primary care may address treatment access and quality gaps by providing care in novel and less stigmatized settings. Yet, PTSD treatments are largely unavailable safety net primary care settings. We aimed to collect data on four potential influences on implementation, including the degree of less-than-best practices, determinants of the current practice, potential barriers and facilitators of implementation, and the feasibility of a proposed strategy for implementing a brief treatment for PTSD. Methods Our mixed-methods developmental formative evaluation (Stetler et al., 2006) was guided by the Consolidated Framework for Implementation Research (CFIR), including a) surveys assessing implementation climate and attitudes towards evidence-based treatments and behavioral health integration and b) semi-structured interviews to identify barriers and facilitators to implementation and need for intervention and system augmentation. Participants were hospital employee stakeholders (N = 22), including primary care physicians, integrated behavioral health clinicians, community wellness advocates, and clinic leadership. We examined frequency and descriptive data from surveys and conducted directed content analysis of interviews. We used a concurrent mixed-methods approach, integrating survey and interview data collected simultaneously using a joint display approach to inform implementation efforts. We utilized a primary care community advisory board (CAB) comprised of employee stakeholders to refine interview guides, and apply findings to the specification of a revised implementation plan. Results Stakeholders described strong attitudinal support, yet therapist time and capacity restraints are major PTSD treatment implementation barriers. Patient engagement barriers such as stigma, mistrust, and care preferences were also noted. Recommendations based on findings included tailoring the intervention to meet existing workflows, system alignment efforts focused on improving detection, referral, and care coordination processes, protecting clinician time for training and consultation, and embedding a researcher in the practice. Conclusions Our evaluation identified key factors to be considered when preparing for implementation of PTSD treatments in safety net integrated primary care settings. Our project also demonstrated that successful implementation of EBTs for PTSD in safety net hospitals necessitates strong stakeholder engagement to identify and mitigate barriers to implementation.

scholarly journals VEIKSMINGI PSICHOLOGINĖS PAGALBOS BŪDAI PSICHOTRAUMATOLOGIJOJE

Psichologija ◽  
2013 ◽  
Vol 47 ◽  
pp. 102-115 ◽  
Author(s):  
E. Kazlauskas
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Good Practice ◽  
Psychological Trauma ◽  
Psychosocial Treatment ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Psychological Treatments ◽  
Evidence Based Treatments

Straipsnyje analizuojamas psichologinės pagalbos būdų suaugusiems asmenims psichotraumatolo­gijoje veiksmingumas. Įsigilinus į 1998–2012 m. paskelbtas metaanalizes, sistemines apžvalgas, geros praktikos vadovus, daromos išvados, kad daugelis tyrimų patvirtina trumpalaikės į traumą orientuotos kognityviosios elgesio terapijos bei nujautrinimo akių judesiais ir perdirbimo (EMDR) terapijos veiksmin­gumą potrauminio streso sutrikimų turintiems asmenims. Tyrimų rezultatai rodo, kad asmenims iš kar­to po trauminio įvykio nerekomenduojama taikyti formalias psichosocialinės intervencijos procedūras, kaip antai psichologinis susirinkimas (angl. debriefing). Yra mokslinių įrodymų, kad trumpalaikė eklekti­nė terapija (BEPP), internetu teikiamos pagalbos ar virtualios realybės taikymo metodai gali veiksmingai padėti asmenims, kurie turi potrauminio streso sutrikimą. Straipsnyje aptariamos tyrimais paremtų psi­chologinės pagalbos metodų diegimo psichotraumatologijos praktikoje problemos. Pagrindiniai žodžiai: psichologinė trauma, potrauminio streso sutrikimas, pagalbos veiksmingumas.   EFFECTIVE PSYCHOLOGICAL TREATMENTS IN PSYCHOTRAUMATOLOGYEvaldas Kazlauskas SummaryThe present article gives an overview of the psycho­logical treatments of psychological trauma. The article is oriented towards practitioners who want to update their knowledge of the recent developments in psychotraumatology. The research findings, based on meta-analyses and good practice guidelines, are presented and the issues related to the implementation of evidence-based treatments are discussed.The study has shown that the critical stress incident debriefing developed by J. T. Mitchell in 1983 (or psychological debriefing) is not recommended imme­diately after trauma. Metaanalysis (Rose et al., 2003; van Emmeric et al., 2002) revealed no positive long-term effects of debriefing immediately after trauma, with indications of negative outcomes in some studies. Practical guidelines of the International Society of Traumatic Stress Studies, as well as other guidelines do not recommend debriefing as a regular procedure for all survivors. Practical, social or legal assistance provided in an empathic way is recommended during the first month after the trauma. Meta-analytical studies published since 1998 concerning the effectiveness of posttraumatic stress disorder treatments demonstrated the efficacy of trauma-focused cognitive-behavioral therapies (TF-CBT) and eye movement reprocessing and desen­sitization therapy (EMDR). Evidence from studies on the effects of a brief eclectic psychotherapy for posttraumatic stress disorder (BEPP), developed by B. Gersons, internet-based treatments, and virtual reality are promising, and these treatments in the future are possible effective alternatives for TF-CBT and EMDR in evidence-based practice. Psychological treatments should be the first option for the treatment of PTSD, with medication used only when the appro­priate psychological treatments are unavailable or the client prefers medication over psychosocial treatment. While a number of RCT studies have shown the efficacy of TF-CBT and EMDR treatment for PTSD, there is still a gap between research and everyday clinical practice. From the practitioner’s point of view, transfer of manual-based methods from RCT efficacy studies to daily practice is not easy. Clinicians are facing complicated cases, and comorbid disorders are widely prevalent with PTSD. We must also be aware that with the new treatments developed, training of these methods and particularly the availability of sys­tematic supervisions are not always easily accessible; this slows down the dissemination and implementation of evidence-based treatments. Clinicians have to take their own responsibility for selecting what is best for a particular client; however, practitioners also need to make decisions based on what science shows to be the most effective treatment.Key words: psychological trauma, posttraumatic stress disorder, effectiveness of treatment.   o:OfficeDocumentSettings> Veiksmingi psichologinės pagalbos būdai psichotraumatologijoje 

Posttraumatic Stress Disorder in Individuals With Autism Spectrum Disorder

2020 ◽  
pp. 113-136
Author(s):  
Katelyn M. Dyason ◽  
Sharna L. Mathieu ◽  
Donna L. Griffiths ◽  
Lara J. Farrell
Keyword(s):  
Autism Spectrum Disorder ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Empirically Supported ◽  
Evidence Based Treatments ◽  
Potential Applications

This chapter summarizes current scientific knowledge around the prevalence, etiology, and developmental course of posttraumatic stress disorder (PTSD) in children and adults in the general population, and—based on the limited scientific literature—what is indicated for those with autism spectrum disorder (ASD). Challenges related to differential diagnosis and measurement of PTSD in ASD are considered and illustrated via a case example. The chapter concludes with an overview of evidence-based treatments for PTSD in people without ASD, and their potential applications for those with ASD. Overall, the limited research on PTSD in ASD thus far points to increased rates of adversity and related psychopathology, but few evidence-based approaches to assessment or treatment of PTSD and other trauma-related symptoms in this population. Future investigations should consider not only PTSD in ASD but also a broader range of potential sources and symptoms of trauma in ASD and work quickly to identify empirically supported assessments and treatments.

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