Moving Effective Treatment for Posttraumatic Stress Disorder to Primary Care: A Randomized Controlled Trial With Active Duty Military

Introduction: Many military service members with PTSD do not receive evidence-based specialty behavioral health treatment because of perceived barriers and stigma. Behavioral health providers in primary care can deliver brief, effective treatments expanding access and reducing barriers and stigma. T...

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Bibliographic Details
Published in:Families systems & health 2017-12, Vol.35 (4), p.450-462
Main Authors: Cigrang, Jeffrey A, Rauch, Sheila A, Mintz, Jim, Brundige, Antoinette R, Mitchell, Jennifer A, Najera, Elizabeth, Litz, Brett T, Young-McCaughan, Stacey, Roache, John D, Hembree, Elizabeth A, Goodie, Jeffrey L, Sonnek, Scott M, Peterson, Alan L
Format: Article
Language:English
Subjects:
Analysis
Behavior therapy
Behavioral health care
Behavioral medicine
Behaviour therapy
Behavioural medicine
Brain
Brain injuries
Brief Psychotherapy
Care and treatment
Clinical trials
Cognitive Behavior Therapy
Cognitive therapy
Cognitive-behavioral therapy
Cognitive-behavioural therapy
Evidence-based medicine
Exposure Therapy
Female
Health behavior
Health Care Psychology
Human
Injuries
Male
Military deployment
Military Duty Status
Military personnel
Post traumatic stress disorder
Posttraumatic Stress Disorder
Primary care
Primary Health Care
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Summary:Introduction: Many military service members with PTSD do not receive evidence-based specialty behavioral health treatment because of perceived barriers and stigma. Behavioral health providers in primary care can deliver brief, effective treatments expanding access and reducing barriers and stigma. The purpose of this randomized clinical trial was to determine if a brief cognitive-behavior therapy delivered in primary care using the Primary Care Behavioral Health model would be effective at reducing PTSD and co-occurring symptoms. Method: A total of 67 service members (50 men, 17 women) were randomized to receive a brief, trauma-focused intervention developed for the primary care setting called Prolonged Exposure for Primary Care (PE-PC) or a delayed treatment minimal contact control condition. Inclusion criteria were significant PTSD symptoms following military deployment, medication stability, and interest in receiving treatment for PTSD symptoms in primary care. Exclusion criteria were moderate or greater risk of suicide, severe brain injury, or alcohol/substance use at a level that required immediate treatment. Assessments were completed at baseline, posttreatment/postminimal contact control, and at 8-week and 6-month posttreatment follow-up points. Primary measures were the PTSD Symptom Scale-Interview and the PTSD Checklist-Stressor-Specific. Results: PE-PC resulted in larger reduction in PTSD severity and general distress than the minimal contact control. Delayed treatment evidenced medium to large effects comparable to the immediate intervention group. Treatment benefits persisted through the 6-month follow-up of the study. Discussion: PE-PC delivered in integrated primary care is effective for the treatment of PTSD and co-occurring symptoms and may help reduce barriers and stigma found in specialty care settings.
ISSN:1091-7527
1939-0602
DOI:10.1037/fsh0000315