Category: Trauma and Stressor Related Disorders and Disasters
Anna Jaffe, Ph.D.
Assistant Professor
University of Nebraska-Lincoln
Lincoln, Nebraska
Tara Galovski, Ph.D.
VA National Center for PTSD, Boston University School of Medicine
Boston, Massachusetts
Debra Kaysen, ABPP, Ph.D.
Professor
Stanford University
Palo Alto, California
Sarah Campbell, Ph.D.
Staff Psychologist, PTSD Outpatient Clinic
Affiliate Investigator, HSR&D
VA Puget Sound Health Care System
Seattle, Washington
Melissa Zielinski, Ph.D.
Assistant Professor
University of Arkansas for Medical Sciences
Little Rock, Arkansas
Kristen Lindgren, ABPP, Ph.D.
University of Washington School of Medicine
Seattle, Washington
Posttraumatic stress disorder (PTSD) is prevalent, with nearly one in ten US adults meeting criteria in their lifetime (Kilpatrick et al., 2013). Beyond the distress and functional impairment from PTSD, additional consequences are common, as PTSD is associated with substance use, depression, anxiety, and physical health problems (Ryder et al., 2018; Walter et al., 2018). Fortunately, there are efficacious treatments for PTSD, including cognitive processing therapy (CPT; Resick et al., 2016) and prolonged exposure (PE; Foa et al., 2007). Two-thirds of those who complete evidence-based PTSD treatment experience a loss of diagnosis, compared to only 16% of those not in active treatment (Bradley et al., 2005). Uptake of these treatments has increased over the past two decades, but remains low (Maguen et al., 2019). Among patients diagnosed with PTSD in the US Veterans Health Administration (VHA), less than 10% completed any session of CPT and less than 4% completed any session of PE (Maguen et al., 2019). Treatment initiation is also low among civilians with recently diagnosed PTSD; nearly half did not engage in any therapy (Nobles et al., 2017). Among those who do initiate a trauma-focused PTSD treatment, more than one-quarter drop out (Edwards-Stewart et al., 2021). Thus, PTSD treatments are underutilized, despite their importance for PTSD recovery.
Consistent with the need to address public health impacts of trauma, the current symposium brings together researchers who are developing and testing approaches to increase access to and engagement in PTSD treatment. High-need trauma-exposed populations will be discussed, including military personnel, veterans, prisoners, and community members with comorbid alcohol misuse. A variety of intervention modalities and settings will be presented, including telephone, text messaging, and in-person approaches.
The first speaker will present on the efficacy of a telephone-based motivational enhancement therapy “check-up” to elicit treatment engagement among service members with PTSD. The second speaker will present a new behavioral activation and social engagement intervention administered in VHA primary care settings, designed to reach and engage veterans with PTSD. The third speaker will present on the adaptation of group-based CPT for delivery in prison settings to increase access to care for people who are incarcerated. The final paper will address the feasibility, acceptability, and efficacy of a text message intervention to increase access to evidence-based strategies for adults with comorbid PTSD and alcohol misuse. Finally, our discussant, an expert in improving access to care through telemedicine technologies, will synthesize the presentations and discuss future directions to improve treatment engagement for individuals with PTSD.
Presenter: Debra Kaysen, ABPP, Ph.D. – Stanford University
Co-author: Thomas Walton, PhD – University of Washington
Co-author: Anna E. Jaffe, Ph.D. – University of Nebraska-Lincoln
Co-author: Scott Graupensper, PhD – University of Washington
Co-author: Issac Rhew, PhD – University of Washington
Co-author: Denise Walker, Ph.D. – University of Washington, Seattle
Presenter: Sarah B. Campbell, Ph.D. – VA Puget Sound Health Care System
Co-author: Tracy Simpson, PhD – VA Puget Sound Health Care System
Co-author: John Fortney, PhD – VA Puget Sound Health Care System
Presenter: Melissa J. Zielinski, Ph.D. – University of Arkansas for Medical Sciences
Presenter: Kristen Lindgren, ABPP, Ph.D. – University of Washington School of Medicine
Co-author: Emily Dworkin, Ph.D. – University of Washington School of Medicine
Co-author: Debra Kaysen, ABPP, Ph.D. – Stanford University
Co-author: Heidi J. Ojalehto, B.S. – UNC Chapel Hill
Co-author: Cynthia Stappenbeck, Ph.D. – Georgia State University
Co-author: Michele Bedard-Giligan, PhD – University of Washington