Family Involvement in Treatment for PTSD (FIT-PTSD): A Brief, Feasible Method for Enhancing Outcomes, Retention, and Engagement

尽管存在治疗创伤后应激障碍的有效方法，但高的治疗中途退学率和次优应答率 仍然很常见。让家庭成员参与治疗是改善结果的一种途径 并提供以退伍军人为中心的护理，对退伍军人创伤后应激障碍门诊护理人员的调查显示，80% 渴望家庭参与。退伍军人管理局已经投入了多年和数百万美元来传播 认知加工疗法(CPT)和长期暴露(PE)治疗创伤后应激障碍。以家庭为基础的干预 补充这两个一线治疗将利用现有的治疗基础设施，同时还 潜在地提高了结果和留存率。拟议的短暂家庭干预(BFI)的初步测试 结果在接受BFI的家庭成员的退伍军人中，从CPT/PE退学的人数减少了50%。那里 对16周时的创伤后应激障碍症状也有很大影响(d=1.12)，有利于BFI组。这样做的目的是 这项研究是为了在全功率样本中测试BFI的有效性。百名退伍军人家庭 将招募成员二人组(n=200)。退伍军人将在1点开始进行常规护理CPT或体育课程 两个退伍军人事务部所在地。家庭成员将随机接受或不接受BFI，为期两个疗程 心理教育和基于技能的礼仪。创伤后应激障碍症状的严重程度和治疗保留将是 主要结果。评估将由独立评估员在基线、6-、12-、18-和26- 几周。家庭成员接受BFI的退伍军人预计辍学率较低，退学率较高 与家庭成员没有接受BFI的退伍军人相比，他们的创伤后应激障碍症状的变化。如果 BFI被发现可以增加CPT/PE的有效性和存留率，它将是一个非常有吸引力的选择 将家庭纳入退伍军人的创伤后应激障碍护理。

Although effective treatments for PTSD exist, high rates of treatment dropout and sub -optimal response rates remain common. Incorporating family members in treatment represents one avenue for improving outcomes and providing Veteran-centered care, and surveys of Veterans in outpatient VA PTSD care indicate that 80% desire family involvement. The VA has invested many years and millions of dollars on the dissemination of Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) for PTSD. A family-based intervention that complements these two first-line treatments would capitalize on existing treatment infrastructure while also potentially boosting outcomes and retention. Preliminary testing of the proposed Brief Family Intervention (BFI) resulted in 50% less dropout from CPT/PE among Veterans whose family members received the BFI. There was also a large impact on PTSD symptoms at 16 weeks (d = 1.12) in favor of the BFI group. The goal of this study is to test the effectiveness of the BFI among a fully-powered sample. One hundred Veteran-family member dyads (n = 200) will be recruited. Veterans will be beginning a course of usual-care CPT or PE at one of two VA sites. Family members will be randomized to receive or not receive the BFI, a two -session psychoeducational and skills-based protocol. PTSD symptom severity and treatment retention will be the primary outcomes. Assessments will be conducted by independent evaluators at baseline, 6 -, 12-, 18-, and 26- weeks. Veterans whose family members receive the BFI are expected to have lower dropout and a greater rate of change in their PTSD symptoms compared to Veterans whose family members do not receive the BFI. If the BFI is found to increase the effectiveness of and retention in CPT/PE, it will be a highly appealing option for incorporating families into Veterans’ PTSD care.