Addressing Attrition from Psychotherapy for PTSD in the U.S. Department of Veterans Affairs
Abstract
:1. PTSD in Veterans of Military Service
2. Current Trauma-Focused Psychotherapies Offered by the Department of Veterans Affairs
3. Dissemination of Evidence-Based Psychotherapies
3.1. Prolonged Exposure (PE)
3.2. Cognitive Processing Therapy (CPT)
4. Attrition from Trauma-Focused PTSD Treatments at the VA
4.1. Factors Influencing Treatment Attrition
4.2. Practical Barriers to VA PTSD Treatment
4.3. Psychological Barriers to VA PTSD Treatment
4.3.1. Avoidance
4.3.2. Perceived Lack of Treatment Efficacy
4.3.3. Treatment-Related Secondary Effects
5. The Need for Treatment
6. Pathways Forward: Options for Reducing Attrition
7. Addressing Practical Barriers
7.1. Shortening the Duration of Sessions and Protocols
7.2. Expanding Telehealth and Smartphone Technology Support
7.3. Offering Intensive Protocols Using Telehealth and Smartphone Technology
8. Addressing Psychological Barriers
8.1. Intensive Protocols to Address Psychological Barriers
8.1.1. Avoidance and Procrastination
8.1.2. Perceived Lack of Improvement and Motivation
8.2. Motivational Interviewing Prior to Trauma-Focused Treatments
8.3. Acceptance and Commitment Therapy as an Alternative Treatment
8.4. Combining Components of Other Therapies
8.4.1. Mindfulness-Based Techniques
8.4.2. Components of Dialectal Behavioral Therapy
8.4.3. Components of Family and Couples Therapies
9. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Lee, A.J.; LaFreniere, L.S. Addressing Attrition from Psychotherapy for PTSD in the U.S. Department of Veterans Affairs. Trauma Care 2023, 3, 274-293. https://doi.org/10.3390/traumacare3040024
Lee AJ, LaFreniere LS. Addressing Attrition from Psychotherapy for PTSD in the U.S. Department of Veterans Affairs. Trauma Care. 2023; 3(4):274-293. https://doi.org/10.3390/traumacare3040024
Chicago/Turabian StyleLee, Alexander J., and Lucas S. LaFreniere. 2023. "Addressing Attrition from Psychotherapy for PTSD in the U.S. Department of Veterans Affairs" Trauma Care 3, no. 4: 274-293. https://doi.org/10.3390/traumacare3040024