Implementation of Multifamily Group Treatment for Veterans With Traumatic Brain Injury

Perlick, Deborah A.; Straits-Tröster, Kristy; Strauss, Jennifer; Norell, Diane; Tupler, Larry A.; Levine, Bruce; Luo, Xiaodong; Holman, Caroline S.; Marcus, Tara; Dixon, Lisa B.; Dyck, Dennis G.

doi:10.1176/appi.ps.001622012

Cited by 32 publications

(34 citation statements)

References 36 publications

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“…After programme completion, VIP family members reported less depression and lower perceived burden [29], and Veterans had better community re-integration and less difficulty managing everyday problems related to TBI [30] compared to the standard of care controls. Perlick and colleagues [31] developed a Veterans Multi-Family Group offered in three phases: (1) joining in which clinicians met with individual families for two or three sessions to evaluate on-going problems and define treatment goals, (2) two three-hour educational workshops about TBI for Veterans with TBI and their caregivers and (3) bimonthly problem-solving multifamily group meetings attended by Veterans and their families for 6 months. Their initial uncontrolled evaluation of this programme documented decreased anger expression as well as increased perceived social support and occupational activity on the part of the Veteran with TBI.…”

Section: Interventions To Assist Families and Caregiversmentioning

confidence: 99%

Impact of TBI on caregivers of veterans with TBI: Burden and interventions

et al. 2017

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Objectives: Describe State-of-the-Art in practice and research in caregiving with individuals, specifically, Veterans with traumatic brain injury (TBI) and the implications for current practice and future research. Sources: Professional literature and personal experience of review panel. Main Outcomes: Unpaid caregiving for individuals with TBI is most often provided by a spouse, parent or other blood relative; the majority of caregivers are women. Although caregiving can be rewarding, it also may create financial burden and psychological stress. Depression among family caregivers occurs four times more frequently than in the general population. Positive coping can help reduce the impact of stress, and Department of Veterans Affairs (VA) programmes are available to ease financial burden. Group interventions show promise in reinforcing and improving positive coping for both family caregivers and Veterans with TBI. Conclusions: Identifying the specific needs of caregivers and families of Veterans with TBI and other traumatic injuries, including post-traumatic stress syndrome (PTSD), will require further longitudinal research. Currently available group interventions and programmes appear to benefit injured Veterans and their family caregivers financially and psychologically. Increased understanding of characteristics of quality family caregiving and its long term costs and benefits is likely to lead to additional improvements in these interventions and programmes.ARTICLE HISTORY

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Section: Interventions To Assist Families and Caregiversmentioning

confidence: 99%

Impact of TBI on caregivers of veterans with TBI: Burden and interventions

et al. 2017

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“…We then move to presentations of more rigorously controlled trials of conjoint interventions with veterans. We conclude with more detailed descriptions of SAT and MFG-MC [9–11], two newer veteran couples interventions for PTSD that have an explicit focus on emotion regulation.…”

Section: Evolution Of Couple- and Family-based Interventions For Ptsdmentioning

confidence: 99%

“…Structured approach therapy (SAT) [9] seeks to improve couples’ ability to manage trauma-related emotions by providing skills training in awareness, labeling, and acceptance of emotions as well as in distress tolerance. Multi-family group for military couples (MFG-MC) [10, 11] teaches skills in mindfulness, distress tolerance, and more advanced emotion-regulation strategies to add this important dimension to communication skills training in subsequent sessions. Fourth and finally, we discuss the limitations and challenges of the work to date and future directions for research in this area.…”

Section: Introductionmentioning

confidence: 99%

The incorporation of emotion-regulation skills into couple- and family-based treatments for post-traumatic stress disorder

et al. 2017

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Post-traumatic stress disorder (PTSD) is a disabling, potentially chronic disorder that is characterized by re-experience and hyperarousal symptoms as well as the avoidance of trauma-related stimuli. The distress experienced by many veterans of the Vietnam War and their partners prompted a strong interest in developing conjoint interventions that could both alleviate the core symptoms of PTSD and strengthen family bonds. We review the evolution of and evidence base for conjoint PTSD treatments from the Vietnam era through the post-911 era. Our review is particularly focused on the use of treatment strategies that are designed to address the emotions that are generated by the core symptoms of the disorder to reduce their adverse impact on veterans, their partners and the relationship. We present a rationale and evidence to support the direct incorporation of emotion-regulation skills training into conjoint interventions for PTSD. We begin by reviewing emerging evidence suggesting that high levels of emotion dysregulation are characteristic of and predict the severity of both PTSD symptoms and the level of interpersonal/marital difficulties reported by veterans with PTSD and their family members. In doing so, we present a compelling rationale for the inclusion of formal skills training in emotional regulation in couple−/family-based PTSD treatments. We further argue that increased exposure to trauma-related memories and emotions in treatments based on learning theory requires veterans and their partners to learn to manage the uncomfortable emotions that they previously avoided. Conjoint treatments that were developed in the last 30 years all acknowledge the importance of emotions in PTSD but vary widely in their relative emphasis on helping participants to acquire strategies to modulate them compared to other therapeutic tasks such as learning about the disorder or disclosing the trauma to a loved one. We conclude our review by describing two recent innovative treatments for PTSD that incorporate a special emphasis on emotion-regulation skills training in the dyadic context: structured approach therapy (SAT) and multi-family group for military couples (MFG-MC). Although the incorporation of emotion-regulation skills into conjoint PTSD therapies appears promising, replication and comparison to cognitive-behavioral approaches is needed to refine our understanding of which symptoms and veterans might be more responsive to one approach versus others.

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“…Results from the Cash and Counseling Demonstration & Evaluation project highlight the greater level of both comfort and access experienced by care recipients when able to hire family members for intimate care or tasks completed outside of the home (San Antonio et al, 2010). Some interventions engage family members and adults with disabilities who are receiving care and demonstrate improvements in decision making, empowerment, or perceived social support (Heller & Caldwell, 2006;Perlick et al, 2013). Additionally, psychoeducational interventions for families caring for adults with schizophrenia have demonstrated positive health outcomes not only for caregivers, but for care recipients as well, including reductions in relapse and hospitalizations (Dixon et al, 2010;Kopelowicz, Zarate, Smith, Mintz, & Liberman, 2003).…”

Section: Personal Level: Individuals With Disabilities Individual Camentioning

confidence: 99%

“…For caregivers of adults and older adults with disabilities, the Veterans Administration operates extensive, model caregiver support programs that provide information, evidence-based interventions, and financial assistance (e.g., Bass et al, 2012;Lutz, Chumbler, Lyles, Hoffman, & Kobb, 2009;Perlick et al, 2013). Throughout the life course, Medicaid influences family caregiving experiences through its role as the primary funding stream for LTSS.…”

Section: State and National Policiesmentioning

confidence: 99%

Introduction to the special issue: Family Support of Persons with Disabilities Across the Life Course

Grossman

Magaña

2016

Journal of Family Social Work

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Implementation of Multifamily Group Treatment for Veterans With Traumatic Brain Injury

Abstract: The results supported implementation of a randomized controlled trial, building in education at the provider and family level.

Cited by 32 publications

References 36 publications

Impact of TBI on caregivers of veterans with TBI: Burden and interventions

Impact of TBI on caregivers of veterans with TBI: Burden and interventions

The incorporation of emotion-regulation skills into couple- and family-based treatments for post-traumatic stress disorder

Introduction to the special issue: Family Support of Persons with Disabilities Across the Life Course

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