"It's Worth It in the End": Veterans' Experiences in Prolonged Exposure and Cognitive Processing Therapy
"It's Worth It in the End": Veterans' Experiences in Prolonged Exposure and Cognitive Processing Therapy
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DOI：
10.1016/j.cbpra.2016.02.003
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发表时间：
2017-02-01
影响因子：
2.9
通讯作者：
Stanley, Melinda A.
中科院分区：
文献类型：
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作者：
Hundt, Natalie E.;Barrera, Terri L.;Stanley, Melinda A.
尽管循证心理疗法（EBP）对创伤后应激障碍（PTSD）有效，并努力传播它们，但只有6- 13%的退伍军人通过退伍军人事务部医疗保健系统寻求治疗。ERP，如延长暴露（PE）和认知加工疗法（CPT）是基于认知的治疗。提供者和患者对基于胰岛素的治疗的耐受性的担忧可能会阻碍其交付和完成。本研究利用定性访谈与23名退伍军人谁完成了至少8个会议的PE或CPT，以引起第一手资料的退伍军人的经验，在这些EBP。结果表明，虽然少数退伍军人报告了最初的症状恶化，但大多数退伍军人报告了积极的经历，并认为尽管有压力，这些EBP是“值得的”。“大多数退伍军人讨论了过早停止治疗的想法，但表示，坚持是鼓励他们的承诺完成，绝望的救济治疗师/小组的支持，和家庭的支持。退伍军人认为，暴露对症状改善做出了重要贡献，更好的自我理解和改变消极或无益的信念也是如此。这些发现表明退伍军人对PE和CPT的满意度，并可能有助于提供者制定策略，以提高依从性和治疗完成率。
Despite the efficacy of evidence-based psychotherapies (EBP) for posttraumatic stress disorder (PTSD) and efforts to disseminate them, only 6-13 % of veterans seeking care through the Veterans Affairs health care system receive these treatments. ERPs such as prolonged exposure (PE) and cognitive processing therapy (CPT) are exposure-based treatments. Provider and patient fears regarding the tolerability of exposure-based treatments likely impede their delivery and completion. The present study utilized qualitative interviews with 23 veterans who completed at least eight sessions of either PE or CPT to elicit firsthand accounts of veterans' experiences in these EBPs. Results suggest that while a minority of veterans reported initial symptom worsening, the majority of veterans reported positive experiences and felt that, despite being stressful, these EBPs were "worth it." Most veterans discussed thoughts of discontinuing treatment prematurely, but stated that adherence was encouraged by their commitment to finishing, desperation for relief therapist/group support, and family support. Veterans believed exposure made an important contribution to symptom improvement, as did greater self-understanding and changing negative or unhelpful beliefs. These findings indicate veteran satisfaction with PE and CPT, and may assist providers to develop strategies to increase adherence and treatment completion.