Veteran Decision-Making around Evidence-Based PTSD Treatment

Osei-Bonsu PE, Bolton R, Wiltsey-Stirman S, Eisen S, Pellowe M, Herz L. Veteran Decision-Making around Evidence-Based PTSD Treatment. Poster session presented at: International Society for Traumatic Stress Studies Annual Symposium; 2014 Nov 7; Miami, FL.

Comparable to other studies, our previous study estimated that < 20% of VA patients with posttraumatic stress disorder (PTSD) have engaged in the two recommended evidence-based psychotherapies for PTSD-cognitive processing therapy (CPT) and prolonged exposure (PE). Given the low rate, we conducted an in-depth exploration of patient decision-making around CPT and PE engagement. We interviewed 13 Veterans with two PTSD-related encounters in FY11 at a VISN 1 medical center. Veterans had either completed (n = 4), partially-completed (n = 4), or never engaged in CPT or PE (n = 5). Completers and partial-completers reported that "being tired" of their PTSD symptoms, their provider's recommendation for CPT or PE, and the nature of the treatment (e.g., its effect on one's emotional state) fed into their decision to begin these treatments. A few noted that these treatments were difficult but self-reassurance and believing that they were not "quitters" facilitated treatment continuation. Interestingly, CPT/PE non-engagers were generally unsure about whether they had had a discussion about CPT or PE with their mental health provider. While thematic saturation was not reached in this study, these early findings point to areas for further exploration and may have implications for marketing strategies that can boost engagement in CPT and PE.