Treatment of active-duty military with PTSD in primary care: Early findings.

Abstract

The study presents early findings from an ongoing pilot study of a cognitive–behavioral treatment for assisting active-duty military members with deployment-related posttraumatic stress disorder (PTSD) designed for use by psychologists working in an integrated primary care clinic. Treatment protocol is based primarily on Prolonged Exposure but also includes elements of Cognitive Processing Therapy that were adapted for use in primary care. Individuals were recruited from the population of patients consulted to the psychologist by primary care providers during routine clinical care. The 15 participants include active-duty or activated reserve Operation Iraqi Freedom and Operation Enduring Freedom veterans seeking help for deployment-related PTSD symptoms, with a PTSD Checklist-Military Version score 32, and interest in treatment for PTSD in primary care. Baseline and 1-month posttreatment follow-up evaluations were conducted by an independent evaluator. Five participants (33%) dropped out of the intervention after one or two appointments. Using the last observation carried forward for intent-to-treat analyses, the results showed that PTSD severity, depression, and global mental health functioning all significantly improved with the intervention. Fifty percent of treatment completers no longer met criteria for PTSD.

Review of exposure therapy: A gold standard for PTSD treatment

“…Indeed, PE has been successfully disseminated to practitioners with varying backgrounds (i.e., those with extensive cognitive behavioral therapy [CBT] training and those without any CBT training [7]) and across cultures all over the world [19]. It has also been modified for many uses, including as a preventative intervention [20] and as a PTSD treatment delivered in a primary care setting [21]. PE provides a model for PTSD treatment that is both straightforward and elegant in its application.…”

RESPECT-PTSD: Re-Engineering Systems for the Primary Care Treatment of PTSD, A Randomized Controlled Trial

“…However, evidence suggesting the effectiveness of briefer cognitive-behavioral treatments delivered by co-located behavioral health specialists is emerging. 15,48 Blended models that combine care management, mental health support, and co-located behavioral health specialists who interact with primary care providers and care managers inperson may be required to treat severe and chronic PTSD in order to offer both psychotherapy and medication management. Although a recent trial of a blended model for treating anxiety disorders failed to find benefits for PTSD patients, the effect size for PTSD was comparable to the effect sizes for patients with other disorders.…”

Psychotherapy for military-related posttraumatic stress disorder: Review of the evidence

“…First, Cigrang et al (2011) delivered four to six 30-minute sessions of PE to active duty OIF/OEF personnel in primary care (N = 15). Patients showed improvements in PTSD (g = 1.1) and depressive symptoms (g = 0.8), with half no longer meeting criteria for PTSD at onemonth follow up.…”