The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis

Haagen, Joris; Smid, Geert E.; Knipscheer, Jeroen W.; Kleber, Rolf J.

doi:10.1016/j.cpr.2015.06.008

Cited by 192 publications

(133 citation statements)

References 63 publications

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“…The only RCT using CAPS for measuring symptom severity reported less severe symptoms both pre- and post CBT-treatment, with mean scores of 74.85 and 39.25, respectively (Hinton et al, 2005). Notably, in a meta-analysis of PTSD treatment efficacy in the military (Haagen, Smid, Knipscheer, & Kleber, 2015), high symptom severity pre-treatment was predictive of smaller treatment effects compared with moderate symptom severity pre-treatment.…”

Section: Discussionmentioning

confidence: 99%

Day patient treatment for traumatic grief: preliminary evaluation of a one-year treatment programme for patients with multiple and traumatic losses

Heus

Hengst

Rie

et al. 2017

European Journal of Psychotraumatology

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Background: Bereaved individuals who have lost a loved one under traumatic circumstances can develop symptoms of Persistent Complex Bereavement Disorder (PCBD) and/or Posttraumatic Stress Disorder (PTSD). This is particularly common in refugees, as they frequently have been confronted with multiple traumatic losses. For patients with severe PTSD and traumatic grief a treatment programme was developed, embedding individual traumatic grief focused therapy in a group-based multidisciplinary day patient treatment programme. The day patient treatment comprised a weekly five-hour programme consisting of three phases with a duration of four months each. Objective: To evaluate the feasibility and potential effectiveness of the treatment programme. Method: Data were analyzed from 16 participants treated between October 2013 and March 2014. PTSD severity and PTSD/PCBD diagnoses were measured during the initial and final phases of treatment using the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Traumatic Grief Inventory Self Report (TGI-SR). One clinical case is presented in more detail. Treatment attendance was also registered and therapist satisfaction was evaluated in a focus group. Results: Thirteen patients (81%) completed the treatment. Each day of the treatment programme was attended by a mean of 76% of the participants. In the focus group, therapists noted symptom reduction in their patients and they therefore regarded Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) as an effective therapy for their patients. During treatment, significant decreases in PTSD severity as well as diagnosable PTSD and PCBD were observed. Conclusions: Results support the feasibility and potential effectiveness of the day patient treatment programme for traumatic grief. The programme appears to be particularly suitable for refugees with severe PTSD and PCBD psychopathology, who may not benefit enough from usual care.

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Section: Discussionmentioning

confidence: 99%

Day patient treatment for traumatic grief: preliminary evaluation of a one-year treatment programme for patients with multiple and traumatic losses

Heus

Hengst

Rie

et al. 2017

European Journal of Psychotraumatology

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“…Several studies (Haagen, Smid, Knipscheer, & Kleber, 2015; Tarrier, Sommerfield, Pilgrim, & Faragher, 2000) suggested that the most important factor associated with a negative treatment outcome is the number of attended trauma-focused therapy sessions. Inconsistency of therapy attendance can be hypothesized to be related to avoidance behaviour.…”

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confidence: 99%

A five-day inpatient EMDR treatment programme for PTSD: pilot study

Méndez

Nijdam

Heide

et al. 2018

European Journal of Psychotraumatology

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Background: Trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) have been demonstrated to be efficacious, but also have considerable non-response and dropout rates. Intensive treatment may lead to faster symptom reduction, which may contribute to treatment motivation and thereby to reduction of dropout. Objective: The aim of the current study was to investigate the feasibility and preliminary effectiveness of an intensive five-day inpatient treatment with Eye Movement Desensitization and Reprocessing (EMDR) and trauma-informed yoga for patients with PTSD. Method: A non-controlled pilot study with 12 adult patients with PTSD was conducted. At baseline the PTSD diagnosis was assessed with the Clinician-Administered PTSD Scale (CAPS-5) and comorbid disorders with the Mini International Neuropsychiatric Interview (MINI). Primary outcome was self-reported PTSD symptom severity (PTSD Check List for DSM-5; PCL-5) measured at the beginning of day 1 (T1), at the end of day 5 (T2) and at follow-up on day 21 (T3). Reliable change indexes (RCI) and clinically significant changes were calculated. Results: From T1 to T3, PTSD symptoms significantly improved with a large effect size (Cohen’s d = 0.91). Nine of the 11 patients who completed treatment showed reliable changes in terms of self-reported PTSD. At T3, two of the patients no longer met criteria for PTSD as measured with the PCL-5. One patient dropped out after the first day. No serious adverse events occurred. Conclusions: The majority of patients in our pilot study experienced symptom reduction consistent with reliable changes in this five-day inpatient treatment with EMDR and yoga. Randomized controlled trials – with longer follow up periods – are needed to properly determine efficacy and efficiency of intensive clinical treatments for PTSD compared to regular treatment. This is one of the first studies to show that intensive EMDR treatment is feasible and is indicative of reliable improvement in PTSD symptoms in a very short time frame.

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“…However, intervention studies in refugee and migrant populations are still lagging greatly behind in comparison with studies in other typical subpopulations exposed to adversities, such as people with somatic diseases (Beltman et al 2010), or war veterans (Haagen et al 2015).…”

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confidence: 99%

Expanding the evidence: key priorities for research on mental health interventions for refugees in high-income countries

Sijbrandij

2017

Epidemiol Psychiatr Sci

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The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis

Cited by 192 publications

References 63 publications

Day patient treatment for traumatic grief: preliminary evaluation of a one-year treatment programme for patients with multiple and traumatic losses

Day patient treatment for traumatic grief: preliminary evaluation of a one-year treatment programme for patients with multiple and traumatic losses

A five-day inpatient EMDR treatment programme for PTSD: pilot study

Expanding the evidence: key priorities for research on mental health interventions for refugees in high-income countries

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