Treatments Veterans Health Administration PTSD specialty program providers report their patients prefer: The role of training and theoretical orientation

Psychol Trauma. 2019 Nov;11(8):837-841. doi: 10.1037/tra0000442. Epub 2019 Feb 28.

Abstract

Objective: A growing empirical literature demonstrates that evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) are effective for veterans. However, use of EBPs for PTSD in the Veterans Health Administration (VHA) remains low, and providers cite patient preference as a factor impacting EBP utilization. The purpose of this exploratory study was to assess the impact of provider factors such as theoretical orientation, occupation, graduate school training, or completion of VHA EBP training on providers' perceptions of patient preferences.

Method: VHA providers in PTSD clinical teams were invited to participate in a national survey (n = 229, response rate 28%) assessing provider demographics and perceived patient preferences.

Results: Having a cognitive-behavioral therapy (CBT) orientation emerged as a robust predictor of reporting that veterans tend to choose EBPs and a non-CBT orientation that patients choose "other" therapies. VHA EBP training also impacted therapists' report of patient preference for an EBP.

Conclusions: Results suggest that theoretical orientation and VHA EBP training meaningfully impact how providers perceive patient preference for EBP. Efforts to increase EBP engagement among veteran patients may benefit from enhancing both therapist and patient education, as well as shared decision-making skills among non-CBT-oriented providers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Cognitive Behavioral Therapy / statistics & numerical data
  • Decision Making, Shared
  • Evidence-Based Practice / statistics & numerical data*
  • Female
  • Health Personnel / education
  • Health Personnel / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Patient Preference / statistics & numerical data*
  • Psychotherapy / statistics & numerical data*
  • Stress Disorders, Post-Traumatic / therapy*
  • United States
  • United States Department of Veterans Affairs / statistics & numerical data
  • Veterans / statistics & numerical data*
  • Veterans Health Services / statistics & numerical data*