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心理健康问题，如创伤后应激障碍（PTSD），这是一种对个人和社会具有潜在代价的衰弱性疾病。无家可归的妇女遭受创伤和创伤后应激障碍的比率通常高于有住房的妇女。虽然有效的，经验验证的治疗创伤后应激障碍，无家可归的妇女不太可能利用自己的心理健康服务，尽管高水平的需要。这项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。 本研究的具体目标对应于三个阶段的活动：目标1/阶段1：收集和分析18岁及以上无家可归妇女的创伤后应激障碍和创伤后应激障碍治疗情况的信息，通过a）有创伤后应激障碍症状的无家可归妇女的焦点小组（2组，每组6-8人），和B）与收容所主任、个案管理员、向无家可归妇女提供心理健康和其他服务（2个小组，每组6-8人）。 目标2/阶段2：根据a）目标1/第一阶段重点小组的调查结果和B）无家可归妇女不断提出的建议和反馈，对现有的基于认知行为疗法的创伤后应激障碍治疗手册进行改编，使其与无家可归妇女的生活相关（2组，每组2个重点小组，每组6-8名妇女），以及收容所主任、个案管理员，向无家可归妇女提供心理健康和其他服务（2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，其中32名妇女，16个在每个参与庇护所，将被分配到任何创伤后应激障碍干预条件或仅评估控制条件在研究干预期间。 这项研究将在第三年达到高潮，有几个产品：1）PTSD干预和手册，适用于收容所环境中无家可归的妇女，2）干预实施和结果变化的试点数据，允许对关键结果进行功率分析，3）两个学术期刊出版物和会议演示文稿，以及4）R 01应用程序的计划，以测试PTSD干预的有效性。

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.