Residential treatment for posttraumatic stress disorder in the Department of Veterans Affairs: A national perspective on perceived effective ingredients.

Abstract

Thirty-eight U.S. Department of Veterans Affairs’s (VA) residential treatment programs for posttraumatic stress disorder took part in a formative evaluation of their programmatic services, including perceptions of effective treatment. From July 2008 through March 2011, face-to-face qualitative interviews were conducted with over 250 VA residential staff. A wide variety of perceived effective treatment elements were noted. The most frequently mentioned elements were evidence-based treatments, frequency and intensity of milieu, staff cohesion, varied programming, and individualized treatment. Implications for VA managers and policy-makers as well as non-VA health care systems and health care providers are discussed.

Use of reflective journaling to understand decision making regarding two evidence-based psychotherapies for PTSD: Practice implications.

“…Tailoring treatments to fit within patients’ culture, repetition of elements or extension of the protocol to allow adequate time for mastery, and integration of elements from the other EBP were commonly endorsed. These findings, in conjunction with other findings regarding treatment adaptation (Cook et al, 2014) are important information for training and program implementation. It may be important to provide additional information about how to adapt the treatment while preserving the key elements of the treatment.…”

“…Veterans who attend VA residential programs often have severe mental health symptoms and complicated life circumstances. Although residential programs provide individualized treatment plans, the VA residential treatment programs are time limited (average length of stay is typically between 6 and 12 weeks; Cook et al, 2014). The providers pointed out that although the EBPs were very helpful to veterans in this relatively short length of stay, veterans require therapy and support in applying knowledge and skill after discharge.…”

“…VA PTSD residential treatment programs typically range from 6 weeks to 3 months (Cook, Dinnen, Simiola, Bernardy, Rosenheck, & Hoff, 2014). Although there is an average length of stay for a program, the length of stay is individualized to the veteran needs and can vary within and across programs.…”

Measuring Use of Evidence-Based Psychotherapy for PTSD in VA Residential Treatment Settings with Clinician Survey and Electronic Medical Record Templates

“…We had two sources of data. First, we used therapist survey data from a large mixed-method longitudinal study examining the implementation of PE and CPT in 38 VA residential treatment programs across the US (14). We used the most recent therapist survey data, which was collected in FY15.…”

“…Relatively few programs reported using PE with any of their patients, and CPT adoption occurred on a discernable continuum ranging from no adoption, to use of only one aspect (e.g., specific worksheets), to strict manual adherence with all patients. Although many therapists expressed belief in the efficacy of EBPs during training, they also attributed perceived efficacy of the residential programs to other elements, such as the residential milieu, staff cohesion, varied programming, and individualized treatment (14).…”