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Brief family involvement enhances veteran homework quality during trauma-focused psychotherapy

APA Citation:

Fernando, M., Fite, R. E., & Thompson-Hollands, J. (2024). Brief family involvement enhances veteran homework quality during trauma-focused psychotherapy. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://doi.org/10.1037/tra0001678

Abstract Created by REACH:

Across various types of therapy approaches, “homework” assignments are common and may enhance treatment success. This multimethod study investigated whether having a family member participate in a brief family intervention impacted Veterans’ completion and quality of homework assigned in their individual posttraumatic stress disorder (PTSD) psychotherapy. 24 Veterans and their romantic partners (n = 24) were randomly assigned either to an intervention group, in which the partner received a brief family intervention, or to a control group, which received treatment as usual. After the 16-week study period, clinicians assessed homework completion rates and homework quality, and couples completed interviews. The findings suggest that a brief family intervention focused on PTSD psychoeducation may improve Veterans’ understanding and application of concepts from their individual treatment.

Focus:

Couples
Trauma
Veterans

Branch of Service:

Multiple branches

Military Affiliation:

Veteran

Subject Affiliation:

Veteran
Spouse of service member or veteran

Population:

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Methodology:

Multi-methods study

Authors:

Fernando, Michelle, Fite, Robert E., Thompson-Hollands, Johanna

Abstract:

Objective: Homework has been shown to improve outcomes in cognitive-behavioral therapy, though less is known about the importance of homework during trauma-focused psychotherapy. Similarly, prior research suggests family context plays a key role in posttraumatic stress disorder (PTSD)-related distress and treatment engagement. One potential way that families can facilitate better treatment outcomes is by promoting homework engagement. This study examined the impact of a brief family intervention (BFI) for PTSD toward this aim. We hypothesized that veterans with PTSD whose family members (FMs) received the BFI would have better homework completion and quality than those who did not receive the BFI. Method: This mixed-methods analysis examined 24 veteran-family dyads enrolled in a randomized clinical trial examining the BFI. All veterans were currently engaged in trauma-focused psychotherapy. Each veteran’s clinician rated their homework quality and completion after each therapy session. A subset of dyads also completed semistructured interviews posttreatment. A rapid qualitative analysis approach was used to examine themes in shifting family behavior post-BFI. Results: Quantitative analyses yielded partial support for our hypotheses: those in the BFI condition had significantly higher clinician-rated homework quality. While participants in the BFI condition had a higher homework completion rate, this difference did not reach statistical significance. Qualitative analyses suggested that the BFI prompted meaningful discussions about PTSD and increased FMs’ use of supportive (rather than accommodative) behavior when responding to PTSD-related distress. Conclusions: Involving FMs in PTSD treatment appears to shift the family context in a manner that improves homework quality in veterans.

Publication Type:

Article
REACH Publication

Keywords:

cognitive-behavioral therapy, brief family intervention, family behavior

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REACH Publication Type:

Research Summary

REACH Newsletter:

  June 2024

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