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Because I asked you to: The role of family in Veterans' engagement in trauma-focused treatment for PTSD.

Meis LA, Spoont MR, Erbes CR, Polusny MA, Noorbaloochi S, Hagel Campbell EM, Eftekhari M, Kattar A, Rosen K, Tuerk P, Velasquez TL, Erickson E, Thompson K, Stewart K, Vang T. Because I asked you to: The role of family in Veterans' engagement in trauma-focused treatment for PTSD. Presented at: International Society for Traumatic Stress Studies Annual Symposium; 2015 Nov 5; New Orleans, LA.


Family members may provide powerful allies in promoting adherence to trauma-focused treatment (TFT) for PTSD, but little is known about how families naturally promote or deter adherence. The degree to which family knows about Veterans' TFT, family attitudes about a TFT, and family behaviors that encourage or discourage approaching trauma-reminders may influence Veterans' initial commitment and subsequent TFT adherence. We surveyed Veterans seeking TFTs for PTSD and a support person (SP) across four VA hospitals and coded Veterans subsequent TFT attendance and homework compliance from hospital records. Data collection is ongoing (anticipated N by conference; Veterans = 470; SPs = 200). Preliminary data was examined in initial analyses (Time 1 N = 264 Veterans; 147 SPs; Administrative data = 241). Regression models indicated that if Veterans told SPs about their EBP at Time 1, Veterans were more likely to complete an adequate dose of treatment (OR = 3.08; 95% CI: 1.06, 8.89). If, during the course of treatment, Veterans' SPs encouraged Veterans to face things previously avoided, Veterans were significantly more likely to obtain an adequate dose of treatment (OR = 3.02; 95% CI: 1.13, 8.05). SPs' reports of TFT credibility at Time 1 significantly predicted Veterans' future homework adherence through the strength of Veterans' early commitment to treatment (bootstrapped indirect effect: B = .09, 95% CI: .03-.16). The degree to which SPs discouraged Veterans from approaching trauma-reminders significantly predicted poorer treatment attendance through reducing Veterans' perceptions of treatment credibility (bootstrapped indirect effects: B = -.26, 95% CI: -.51 through -.06). Findings indicate that family awareness of treatment and family behaviors predict EBP session adherence. Implications and limitations will be discussed.

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