“I Need to Talk About It”: A Qualitative Analysis of Trauma-Exposed Women’s Reasons for Treatment Choice

Abstract

A significant proportion of individuals suffering from posttraumatic stress disorder do not seek or receive effective treatment. Understanding the reasons why an individual chooses to seek treatment or prefers one treatment to another is a critical step to improve treatment seeking. To begin to understand these reasons, we conducted a qualitative analysis of the reasons women gave for choosing a cognitive-behavioral treatment, prolonged exposure (PE), or a pharmacological treatment, sertraline (SER). A community sample of women with trauma histories were asked to view standardized rationales, to choose among PE, SER, or no treatment, and to give 5 reasons for their choice. Women indicated that they were more likely to prefer the psychotherapy to the medication. Across reasons given, the most commonly cited reason for treatment preference highlighted why or how the treatment worked (e.g., I need to talk about it); and this reason emerged as the strongest predictor of preference for PE. Understanding this role of perceived treatment mechanism may aid clinicians and public health policy officials to identify and address help-seeking barriers regarding treatment.

Law enforcement preferences for PTSD treatment and crisis management alternatives

“…For instance, three analog studies conducted with student samples (Becker et al, 2007;Tarrier, Liversidge, & Gregg, participants ranked CBT interventions with a strong evidence base (including those that involved exposure) as highly preferred over other forms of psychotherapy and/or medication. This finding was replicated in one non-collegiate sample of women who responded to advertisements seeking females with trauma histories (Angelo, Miller, Zoellner, & Feeny, 2008). Seventy-one percent of the Angelo et al sample had experienced a Criterion A event and 53% met PTSD criteria.…”

“…For this reason, it could be of practical importance to determine what interventions, processes or therapies would be the most and least attractive to law enforcement personnel. For instance, officers might show similar preferences to previously studied samples (i.e., Angelo et al, 2008;Becker et al, 2007;Tarrier et al, 2006;Zoellner et al, 2003). If officers do show a preference for EBT, this preference (along with the evidence-base) could be used to encourage police department therapists to offer EBT and to design departmental programs and guidelines for this population.…”

“…To our knowledge, aside from Angelo et al (2008), no study has examined a predominately non-collegiate sample's perceptions of PTSD treatment options. Furthermore, because Angelo et al only gave participants the option of one type of psychotherapy (exposure) versus medication or no treatment, no study has explored perceptions about different types of psychotherapy along with medication in a non-collegiate population at high risk for traumatic events.…”

Therapeutic treatments for PTSD : does type of treatment impact help seeking behaviors in a military sample?

“…A large body of research has been conducted to show which treatments for PTSD have the most appeal and preference. Evidence generally shows a preference for 6 therapeutic treatment over medication treatment (Angelo, Miller, Zoellner, & Feeny, 2008;Becker, Darius, & Schaumberg, 2007;Becker et al, 2009;Cochran et al, 2007;Feeny, Zoellner, Mavissakalian, and Roy-Byrne, 2009;Jaeger et al, 2010: Reger et al, 2013Roy-Byrne et al, 2003;Zoellner et al, 2003). Some studies have explored preferences among the different therapeutic approaches for PTSD (Becker, Darius, & Schaumberg, 2007;Becker et al, 2009;Reger et al, 2013;Tarrier, Liversidge, & Gregg, 2006).…”

“…Some of the preference studies did examine reasons why certain treatments were selected, and "perceived efficacy of treatment" was a strong predictor of treatment choice (Angelo et al, 2008;Cochran et al, 2007;Zoeller et al, 2003). In a literature review intended to highlight factors associated with treatment preference for PTSD, Jeager at al.…”