Family Involvement in Treatment for PTSD (FIT-PTSD): A Brief, Feasible Method for Enhancing Outcomes, Retention, and Engagement

家庭参与治疗 PTSD (FIT-PTSD)：一种增强结果、保留和参与度的简短、可行的方法

• 批准号: 10361786
• 负责人: Johanna Thompson-Hollands
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10361786
• 关键词: Adult; Afghanistan; Ambulatory Care Facilities; Award; Caring; Cognitive; Communication; Complement; Cues; DSM-V; Data; Department of Defense; Distress; Dose; Dropout; Effectiveness; Evidence based practice; Family; Family member; Feedback; Funding; Goals; Individual; Infrastructure; Intervention; Interview; Investments; Iraq; Memory; Methods; Outcome; Outpatients; Persons; Post-Traumatic Stress Disorders; Protocols documentation; Provider; Psychotherapy; Quality of life; Randomized; Randomized Controlled Trials; Research; Sampling; Severities; Site; Surveys; Symptoms; Telephone; Testing; Trauma; United States Department of Veterans Affairs; Veterans; Veterans Health Administration; Weather; acceptability and feasibility; base; design; effective therapy; effectiveness implementation study; effectiveness testing; experience; group intervention; implementation intervention; improved; improved outcome; intervention effect; loved ones; primary outcome; psychoeducation; psychoeducational; rate of change; recruit; response; retention rate; skills; symptom treatment; therapy design; treatment as usual

Although effective treatments for PTSD exist, high rates of treatment dropout and sub -optimal response rates remain common. Incorporating family members in treatment represents one avenue for improving outcomes and providing Veteran-centered care, and surveys of Veterans in outpatient VA PTSD care indicate that 80% desire family involvement. The VA has invested many years and millions of dollars on the dissemination of Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) for PTSD. A family-based intervention that complements these two first-line treatments would capitalize on existing treatment infrastructure while also potentially boosting outcomes and retention. Preliminary testing of the proposed Brief Family Intervention (BFI) resulted in 50% less dropout from CPT/PE among Veterans whose family members received the BFI. There was also a large impact on PTSD symptoms at 16 weeks (d = 1.12) in favor of the BFI group. The goal of this study is to test the effectiveness of the BFI among a fully-powered sample. One hundred Veteran-family member dyads (n = 200) will be recruited. Veterans will be beginning a course of usual-care CPT or PE at one of two VA sites. Family members will be randomized to receive or not receive the BFI, a two -session psychoeducational and skills-based protocol. PTSD symptom severity and treatment retention will be the primary outcomes. Assessments will be conducted by independent evaluators at baseline, 6 -, 12-, 18-, and 26- weeks. Veterans whose family members receive the BFI are expected to have lower dropout and a greater rate of change in their PTSD symptoms compared to Veterans whose family members do not receive the BFI. If the BFI is found to increase the effectiveness of and retention in CPT/PE, it will be a highly appealing option for incorporating families into Veterans’ PTSD care.

尽管存在针对 PTSD 的有效治疗方法，但治疗中途退出率很高且缓解率次优 让家庭成员参与治疗仍然很常见。 并提供以退伍军人为中心的护理，对 VA PTSD 门诊退伍军人的调查表明，80% VA 已投入多年和数百万美元用于传播 针对 PTSD 的认知处理疗法 (CPT) 和长期暴露疗法 (PE) 一种基于家庭的干预措施。 补充这两种一线治疗将利用现有的治疗基础设施，同时也 对拟议的简短家庭干预（BFI）的初步测试可能会提高结果和保留率。 其家庭成员获得 BFI 的 CPT/PE 退伍军人的辍学率减少了 50%。 对 16 周时的 PTSD 症状也有很大影响（d = 1.12），有利于 BFI 组的目标。 研究的目的是在一百个退伍军人家庭中测试 BFI 的有效性。 将招募成对的成员（n = 200），退伍军人将开始常规护理 CPT 或 PE 课程。 两个 VA 站点的家庭成员将随机接受或不接受 BFI，分两次进行。 心理教育和基于技能的方案将是 PTSD 症状的严重程度和治疗的保留。 主要结果将由独立评估员在基线、6-、12-、18-和26-进行。 家庭成员接受 BFI 的退伍军人预计辍学率较低，比例较高。 与家庭成员未接受 BFI 的退伍军人相比，他们的 PTSD 症状发生了变化。 研究发现 BFI 可以提高 CPT/PE 的有效性和保留率，对于以下人群来说，这将是一个非常有吸引力的选择 将家庭纳入退伍军人的创伤后应激障碍 (PTSD) 护理中。