Cognitive Behavioral Therapy for Homeless Women with PTSD

描述（由申请人提供）：暴露于创伤性事件可能导致精神健康问题，如创伤后应激障碍（PTSD），这是一种对个人和社会具有潜在昂贵影响的衰弱状态。无家可归的妇女患创伤和创伤后应激障碍的比率通常高于有房妇女。虽然有有效的、经经验验证的创伤后应激障碍治疗方法，但无家可归的妇女不太可能利用心理健康服务，尽管她们的需求很高。这里提出的为期三年的研究解决了治疗研究中的一个关键空白，以满足无家可归妇女的心理健康服务需求。本研究的具体目标与三个阶段的活动相对应：目标1/阶段1：通过a)有PTSD症状的无家可归妇女的焦点小组（2组，每组6-8人）收集和分析关于创伤后应激障碍和18岁及以上无家可归妇女的创伤后应激障碍治疗背景的信息，b)有收容所主任、病例管理人员和无家可归妇女心理健康和其他服务提供者的焦点小组（2组，每组6-8人）。2 /第二阶段目标:开发一个适应现有的认知行为治疗(CBT)的PTSD治疗手册让无家可归的妇女的生活相关的基于)发现目标1 /第一阶段焦点小组,和b)持续的建议和反馈无家可归的妇女(2套2焦点小组,每组)6 - 8妇女,和住所董事、经理,和无家可归的妇女心理健康和其他服务提供商(2套2焦点小组,每组6 - 8人)。目标3/第3阶段：对有创伤后应激障碍症状的无家可归妇女进行适应性干预的试点测试。我们提出了一个随机设计，在研究干预期间，32名妇女，两个参与庇护所各16名，将被分配到创伤后应激障碍干预条件或仅评估的对照条件。

DESCRIPTION (provided by applicant): Exposure to traumatic events may lead to mental health problems such as posttraumatic stress disorder (PTSD), a debilitating condition with potentially costly implications for the individual and society. Homeless women suffer from traumas and PTSD at rates typically higher than among housed women. Although effective, empirically validated treatments for PTSD are available, homeless women are unlikely to avail themselves of mental health services despite high levels of need. The three-year study proposed here addresses a critical gap in treatment research to meet the mental health service needs of homeless women. The Specific Aims of this study correspond with three phases of activities: Aim 1/Phase 1: Gather and analyze information on the context of PTSD and PTSD treatment for homeless women ages 18 and older through a) focus groups with homeless women having symptoms of PTSD (2 groups, 6-8 persons per group), and b) focus groups with shelter directors, case managers, and providers of mental health and other services to homeless women (2 groups, 6-8 persons per group). Aim 2/Phase 2: Develop an adaptation of an existing cognitive behavioral therapy (CBT)-based PTSD treatment manual to make it relevant for the lives of homeless women based on a) findings from Aim 1/ Phase I focus groups, and b) ongoing advice and feedback from homeless women (2 sets of 2 focus groups, 6-8 women per group), and shelter directors, case managers, and providers of mental health and other services to homeless women (2 sets of 2 focus groups, 6-8 persons per group). Aim 3/Phase 3: Conduct a pilot test of the adapted intervention with homeless women who have symptoms of PTSD. We propose a randomized design in which 32 women, 16 in each of two participating shelters, will be assigned to either the PTSD intervention condition or to an assessment-only control condition during the study intervention period. This study will culminate in Year 3 with several products: 1) a PTSD intervention and manual adapted for use with homeless women in shelter settings, 2) pilot data on intervention implementation and variation in outcomes that allow power analyses for key outcomes, 3) two scholarly journal publications and a conference presentation, and 4) a plan for an R01 application to test the efficacy of the PTSD intervention.