A Formative Evaluation of Two Evidence-Based Psychotherapies for PTSD in VA Residential Treatment Programs

Between July 2008 and March 2011, 38 U.S. Department of Veterans Affairs (VA) residential treatment programs for posttraumatic stress disorder (PTSD) participated in a formative evaluation of their programmatic services, including evidenced‐based treatments (EBTs). Face‐to‐face qualitative interviews were conducted with over 250 staff by an independent psychologist along with onsite participant observations. This evaluation coincided with a national VA dissemination initiative to train providers in two EBTs for PTSD: prolonged exposure (PE) and cognitive processing therapy (CPT). A substantial proportion of eligible (based on professional background) residential treatment providers received training in PE (37.4%) or CPT (64.2%), with 9.5% completing case consultation or becoming national trainers in each therapy respectively. In semistructured interviews, providers reported that their clinical programs had adopted these EBTs at varying levels ranging from no adoption to every patient receiving the full protocol. Suggestions for improving the adoption of PE and CPT are noted, including distilling manualized treatments to essential common elements. Traditional and Simplified Chinese s by AsianSTSS 標題：兩個實証PTSD心理治療在VA住宿治理項目的成長評估 撮要：在2008年7月到2011年3月期間，38個美國退役軍人事務部門(VA)創傷後壓力症(PTSD)住宿治理項目作了成長評估，包括實証治療(EBTS)。由一位獨立心理學家(及現場觀察者監察下)向超過250位職員進行定性面談。而同時進行的是一個全國VA訓練治療師計劃：訓練PTSD的兩種EBTS，即延長暴露(PE)和認知處理治療(CPT)。其中合資格(基於專業背景)的住宿治理工作人員的相當部份接受了PE(37.4%)或CPT(64.2%)的訓練，而有9.5%分別完成PE或CPT個案諮詢訓練或成為全國認可訓練師。在半結構面見中，工作人員報告有關採用EBT在臨床服務的情況，從未有採用到每一病人中使用全套方案都有。本文亦討論了改善採納PE和CPT的方法，如提取手冊式治療的重要相同元素等。 标题：两个实证PTSD心理治疗在VA住宿治理项目的成长评估 撮要：在2008年7月到2011年3月期间，38个美国退役军人事务部门(VA)创伤后压力症(PTSD)住宿治理项目作了成长评估，包括实证治疗(EBTS)。由一位独立心理学家(及现场观察者监察下)向超过250位职员进行定性面谈。而同时进行的是一个全国VA训练治疗师计划：训练PTSD的两种EBTS，即延长暴露(PE)和认知处理治疗(CPT)。其中合资格(基于专业背景)的住宿治理工作人员的相当部份接受了PE(37.4%)或CPT(64.2%)的训练，而有9.5%分别完成PE或CPT个案咨询训练或成为全国认可训练师。在半结构面见中，工作人员报告有关采用EBT在临床服务的情况，从未有采用到每一病人中使用全套方案都有。本文亦讨论了改善采纳PE和CPT的方法，如提取手册式治疗的重要相同元素等。