Sticking it out in trauma-focused treatment for PTSD: It takes a village
Research Report:
Research SummaryAPA Citation:
Meis, L. A., Noorbaloochi, S., Hagel Campbell, E. M., Erbes, C. R., Polusny, M. A., Velasquez, T. L., ... & Spoont, M. R. (2019). Sticking it out in trauma-focused treatment for PTSD: It takes a village. Journal of Consulting and Clinical Psychology, 87(3), 246-256. http://dx.doi.org/10.1037/ccp0000386
Abstract Created by REACH:
Trauma-focused treatment is known to help those who struggle with posttraumatic stress disorder (PTSD) experience fewer symptoms, but the number of Veterans who drop out before completing PTSD treatment is concerning. This study examined how social control (i.e., explicit efforts by a loved one to get their Veteran to complete PTSD treatment and face any difficult emotions along the way) and PTSD symptom accommodation (i.e., a loved one changing his/her behaviors to lessen or avoid the stress that their Veteran may experience during PTSD treatment) were related to Veterans’ treatment completion. Whether these associations varied by the Veteran’s perceived relationship strain (i.e., feeling like a loved one is critical of them or stress in the relationship) was also explored. Veterans who felt comfortable in their relationship with their loved one and received encouragement to face the difficult phases of treatment (i.e., experienced social control) were more likely to complete treatment.
Focus:
Trauma
Branch of Service:
Army
Military Affiliation:
Veteran
Subject Affiliation:
Spouse of service member or veteran
Veteran
Other
Population:
Adulthood (18 yrs & older)
Middle age (40 - 64 yrs)
Methodology:
Cross-Sectional Study
Quantitative Study
Authors:
Meis, Laura A., Noorbaloochi, Siamak, Hagel Campbell, Emily M., Erbes, Christopher R., Polusny, Melissa A., Velasquez, Tina L., Bangerter, Ann, Cutting, Andrea, Eftekhari, Afsoon, Rosen, Craig S., Tuerk, Peter W., Burmeister, Lori B., Spoont, Michele R.
Abstract:
Objective: One in 3 veterans will dropout from trauma-focused treatments for posttraumatic stress disorder (PTSD). Social environments may be particularly important to influencing treatment retention. We examined the role of 2 support system factors in predicting treatment dropout: social control (direct efforts by loved ones to encourage veterans to participate in treatment and face distress) and symptom accommodation (changes in loved ones’ behavior to reduce veterans’ PTSD-related distress). Method: Veterans and a loved one were surveyed across 4 VA hospitals. All veterans were initiating prolonged exposure therapy or cognitive processing therapy (n = 272 dyads). Dropout was coded through review of VA hospital records. Results: Regression analyses controlled for traditional, individual-focused factors likely to influence treatment dropout. We found that, even after accounting for these factors, veterans who reported their loved ones encouraged them to face distress were twice as likely to remain in PTSD treatment than veterans who denied such encouragement. Conclusions: Clinicians initiating trauma-focused treatments with veterans should routinely assess how open veterans’ support systems are to encouraging veterans to face their distress. Outreach to support networks is warranted to ensure loved ones back the underlying philosophy of trauma-focused treatments. (PsycINFO Database Record (c) 2020 APA, all rights reserved)
Publisher/Sponsoring Organization:
American Psychological Association
Publication Type:
Article
REACH Publication
Author Affiliation:
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, LAM
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, SN
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, EMHC
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, CRE
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, MAP
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, TLV
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, AB
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, AC
Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System, AE
Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System,CSR
Sheila C Johnson Center for Clinical Services, University of Virginia, PWT
Phoenix VA Health Care System, LBB
Center for Care Delivery & Outcomes Research, Minneapolis Veterans Affairs Health Care System, MRS
Keywords:
PTSD, social control, accommodation, evidenced-based treatments, dropout
REACH Publication Type:
Research Summary
Sponsors:
Department of Defense’s Congressionally Directed Medical Research Program, US; Grant Number: W81XWH-12-1-0619
Department of Veterans Affairs, US; Grant Number: HSR&D CDA 10-035; RRP 12-229
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