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Post-traumatic Stress Disorder

Post-traumatic Stress Disorder

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Development of a Virtual Reality Assessment of Everyday Living Skills

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A Quantitative Test of an Implementation Framework in 38 VA Residential PTSD Programs.

Joan M Cook¹, Stephanie Dinnen, Richard Thompson

¹Yale School of Medicine, NEPEC/182, 950 Campbell Avenue, West Haven, CT, 06516, USA, joan.cook@yale.edu.

Administration and Policy in Mental Health

|September 10, 2014

Summary

Implementing Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) for PTSD in VA programs requires organizational support. A supportive context is key for both PE and CPT effectiveness, influencing provider adoption and patient outcomes.

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Area of Science:

Psychology
Clinical Psychology
Mental Health Services Research

Background:

Posttraumatic Stress Disorder (PTSD) is a significant concern within the veteran population.
Evidence-based psychotherapies (EBPs) like Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) are recommended for PTSD treatment.
Understanding the implementation of these EBPs in real-world settings is crucial for improving care.

Purpose of the Study:

To examine the implementation of PE and CPT in Department of Veterans Affairs (VA) residential PTSD treatment programs.
To identify factors associated with the successful implementation of these EBPs.
To inform future efforts to disseminate and implement EBPs for PTSD.

Main Methods:

A cross-sectional online survey was administered to 201 providers across 38 VA residential PTSD programs.
The survey assessed the implementation of individual PE and individual/group CPT.
Statistical analyses examined the relationship between organizational context, provider perceptions, and implementation outcomes.

Main Results:

For PE, a supportive organizational context and positive treatment views were linked to implementation.
For both individual and group CPT, only a supportive organizational context significantly predicted outcomes.
Dedicated resources, time, incentives, and mandates formed the supportive organizational context.

Conclusions:

Organizational support is a critical factor for the successful implementation of PE and CPT in VA PTSD programs.
While positive provider attitudes may aid PE adoption, consistent organizational support is essential for both PE and CPT.
Future implementation strategies should prioritize strengthening the organizational context to enhance EBP delivery and effectiveness.