Symposia
Trauma and Stressor Related Disorders and Disasters
Debra Kaysen, ABPP, Ph.D.
Professor
Stanford University
Palo Alto, California
Thomas Walton, PhD
Research Scientist
University of Washington
Seattle, Washington
Anna E. Jaffe, Ph.D.
Assistant Professor
University of Nebraska-Lincoln
Lincoln, Nebraska
Scott Graupensper, PhD
Acting Assistant Professor
University of Washington
Seattle, Washington
Issac Rhew, PhD
Research Associate Professor
University of Washington
seattle, Washington
Denise Walker, Ph.D.
Research Professor
University of Washington, Seattle
Seattle, Washington
Introduction: Rates of PTSD in the military are high and although effective treatments exist, they are underutilized, with most service members not presenting for treatment. Motivational Enhancement Therapy (MET) “check-ups”, are brief interventions to elicit treatment engagement for those who are nontreatment seeking. Extant literature supports MET as a means to increase treatment adherence and treatment response rates although this has not been well studied for PTSD.
Method: One hundred and sixty-one active duty service members were randomized to MET or Treatment as Usual (TAU, treatment resource and referral). MET participants (n=82) received up to three 45-60 minute telephone sessions in weeks 1, 4 and 8 (post baseline) whereas TAU participants (n=79) were mailed PTSD resource and referral information. Follow-up assessments were conducted immediately 6-weeks, 3-, and 6- months post-baseline.
Results: Participants reported finding aspects of MET delivery helpful, such as telephone-sessions (95.8%) and optional confidential or anonymous participation (78.9%). Intervention engagement was high; 92.6% completed the primary MET session, 82.7% completed one and 65.4% completed two optional follow-up sessions. A mixed effect model indicated that engaging with evidence-based treatments increased significantly among both groups, but there were no significant differences between MET and TAU at any time point (6-week AOR=2.23, p=.158; 3-month AOR=1.20, p=.74; 6-month AOR=2.18, p=.165). Similarly, PTSD symptom severity significantly decreased for both groups, but there were no significant differences between MET and TAU at follow-up (3-month b= -0.59, p=.750; 6-month b= -1.49, p=.421).
Conclusions: High levels of engagement with the MET intervention suggest that phone based and confidential interventions may have a place within systems as a means to reach out to individuals with PTSD who are reluctant to engage in care. Results suggest that both MET and high quality referral options have promise as means of increasing evidence based treatment engagement and decreasing PTSD for service members with PTSD. As PTSD is associated with deleterious health, occupational and psychological effects, there is clear need for interventions to bridge the gap between those who are not treatment seeking and existing services, thereby enhancing reach and impact of existing services.