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

虽然存在有效的治疗PTSD的方法，但高的治疗退出率和次优反应率 仍然常见。让家庭成员参与治疗是改善结果的一个途径 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的调查表明，80%的 渴望家庭参与。退伍军人事务部已投入多年和数百万美元的传播， 认知加工疗法（CPT）和PTSD的长期暴露（PE）。以家庭为基础的干预措施， 补充这两个一线治疗将利用现有的治疗基础设施，同时也 潜在地提高结果和保留率。初步测试拟议的简短家庭干预（BFI） 在家庭成员接受BFI的退伍军人中，CPT/PE的辍学率降低了50%。那里 在16周时，BFI组对PTSD症状也有很大的影响（d = 1.12），有利于BFI组。这个目标 研究的目的是在一个完全有效的样本中测试BFI的有效性。百名退伍军人家属 将招募成员二联体（n = 200）。退伍军人将开始一个过程中的日常护理CPT或PE在一个 两个地点。家庭成员将被随机分配接受或不接受BFI， 心理教育和基于技能的方案。PTSD症状严重程度和治疗保留率将是 主要成果。将由独立评价者在基线、第6、12、18和26天进行评估。 周家庭成员接受BFI的退伍军人预计辍学率较低，辍学率较高 与家庭成员没有接受BFI的退伍军人相比，他们的PTSD症状发生了变化。如果 BFI被发现可以提高CPT/PE的有效性和保留率，这将是一个非常有吸引力的选择， 将家庭纳入退伍军人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.