Symposia
Trauma and Stressor Related Disorders and Disasters
Elizabeth Goetter, Ph.D.
Massachusetts General Hospital
Charlestown, Massachusetts
Elyse Lynch, BA
Research Assistant
Massachusetts General Hospital
Charlestown, Massachusetts
Molly Nadel, B.A.
Clinical Research Coordinator
Massachusetts General Hospital
Winchester, Massachusetts
Laura Harward, LiCSW
Social Worker
Massachusetts General Hospital
Charlestown, Massachusetts
Edward Wright, PhD
Psychologist
Massachusetts General Hospital
Boston, MA
Group or cohort-based treatments are typical modalities for veterans with PTSD. In addition to patient satisfaction with the two formats, the study examined group cohesion in an intensive, PTSD treatment program and its relation to outcome.
In an IRB-approved, data repository study, veterans (N=190, 81% male, 74% white) attended a two-week intensive treatment program for PTSD either in-person (pre-COVID) or hybrid virtual. Assessment was done using the Posttraumatic Stress Disorder Symptom Checklist (PCL-5) and the Group Climate Questionnaire (GCQ), a multidimensional assessment of group cohesion assessing anger or tension in the group (Conflict) and positive working group atmosphere (Engagement). Anonymous patient satisfaction data were also collected.
Across the full sample, PCL-5 change was correlated with Engagement (r = .21, p < .01) and Conflict (r = -.19, p < .05). Mean levels of Engagement were not significantly different by format (p = .093), but in the virtual format, there was significantly less group conflict than the in-person format, p</em>=.007. In the virtual environment, there was a significant inverse relationship between PCL-5 change and Conflict (r = -0.199; p = .026), but no significant relationship between PCL-5 change and Engagement (p = .11). In-person, there was no significant relationship between PCL-5 change and Conflict (p = .18) but there was a significant relationship between PCL-5 change and Engagement (r = .3846, p</em> = .016). Patients were satisfied with the care they received pre-COVID, in-person (90% strongly agreed) and post-COVID, hybrid format (74% strongly agreed).
Group cohesion was associated with PTSD symptom change in an intensive treatment program, but the pattern of results differed by format. Providers should take steps to foster group engagement (particularly in in-person settings) and minimize group conflict, which may be particularly detrimental in virtual treatment settings. Patient satisfaction was generally high in both formats though this should be explored further as initial qualitative findings suggest more enthusiasm for in-person format.