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2015 HSR&D/QUERI National Conference Abstract

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1145 — Psychotherapy Practices for Patients with Posttraumatic Stress Disorder (PTSD) among Community-Based Providers in Texas

Finley EP, South Texas Veterans Health Care System; University of Texas Health Science Center at San Antonio; Noel PH, University of Texas Health Science Center at San Antonio; Lee S, South Texas Veterans Health Care System; Pugh MJ, South Texas Veterans Health Care System; University of Texas Health Science Center at San Antonio; Garcia HA, South Texas Veterans Health Care System; Pugh JA, South Texas Veterans Health Care System; University of Texas Health Science Center at San Antonio;

Objectives:
National health care reforms and the Veterans Choice Act are expected to increase the number of Veterans seeking care outside of VA, but little is known about community providers' attitudes and practices in PTSD care, particularly their use of evidence-based psychotherapies (EBPs). We assessed psychotherapy practices of community providers serving Veterans with PTSD in Texas and their preferences for partnering with VA.

Methods:
We invited Texas mental health providers to participate in a mailed or online survey. Providers were identified using state licensing board rosters, and included all clinical and counseling psychologists with listed email addresses (n = 3,986), and stratified samples of social workers (n = 500), marriage and family therapists (n = 500), and professional counselors (n = 500). We also invited 106 providers who had participated in a recent state-sponsored cognitive processing therapy (CPT) training. Eligiblility criteria included maintaining an active practice ( > 1 patient in past year) and working primarily with adults.

Results:
463 eligible respondents returned surveys (13.8% response rate). Providers reported treating approximately 3,398 Veterans with PTSD in the past year (range 0-200; M = 7.9, SD = 20.5), using a variety of therapeutic approaches for PTSD. Half of providers (50.1%) reported conducting exposure or detailed reprocessing of traumatic events with more than 50% of their PTSD patients. Only 18.0% reported conducting psychotherapy for PTSD following a treatment manual with more than 50% of their PTSD patients; 58% reported never following a treatment manual. More than half of respondents (57.6%) reported being interested or very interested in increasing partnership with VA to provide mental health care to Veterans, with similar numbers reporting interest in online (53.1%) or in-person (45.4%) trainings in use of EBPs.

Implications:
Although community-based mental health providers in Texas report treating significant numbers of Veterans with PTSD, many do not consistently use EBPs for PTSD. Community providers report high levels of interest in increased training and partnership with VA to provide care for Veterans.

Impacts:
As growing numbers of Veterans seek PTSD care services in community settings, these findings suggest VA has an important opportunity to partner with community providers to ensure Veterans receive high-quality care.