Language
English
Publication Date
12-1-2024
Journal
Medical Care
DOI
10.1097/MLR.0000000000002070
PMID
39514500
PMCID
PMC11548821
PubMedCentral® Posted Date
11-11-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Background: Up to 50% of veterans drop out of trauma-focused evidence-based psychotherapies (TF-EBP) without completing treatment or recovering; evidence suggests this is in part because their posttraumatic stress disorder (PTSD) care is insufficiently patient-centered. There is also evidence that measurement-based care (MBC) for mental health should be personalized to the patient, yet this is not common practice in VA PTSD care.
Objectives: To explore veterans' experiences and preferences for aligning measurement-based PTSD care with their own treatment goals.
Method: Qualitative interviews were conducted with veterans (n=15) with PTSD who had received at least 2 sessions of a TF-EBP.
Measures: Survey on the administration of outcomes questionnaires and demographics and an interview about their most recent TF-EBP episode.
Results: Half of veterans had symptom-focused goals and half did not; all had at least one treatment goal that was not symptom-focused. They typically met their goals about functioning and coping skills but not their symptom reduction goals. We found veterans overall were receptive to MBC but preferred patient-reported outcomes measures about functioning, wellbeing, coping skills, and understanding their trauma more than the commonly used PTSD symptom scale (the PCL-5).
Conclusions: Many veterans in this sample disliked the PCL-5 because it reinforced their maladaptive cognitions. Such veterans might be more receptive to MBC if offered patient-report outcomes measures that better align with their functional and wellbeing goals. For many goal/outcome areas, psychometrically sound measures exist and require better implementation in PTSD care. For some areas, scale development is needed.
Keywords
Humans, Stress Disorders, Post-Traumatic, Male, Veterans, Female, Patient-Centered Care, Middle Aged, Adult, Patient Preference, Qualitative Research, United States, Aged, Surveys and Questionnaires, Psychotherapy, Interviews as Topic
Published Open-Access
yes
Recommended Citation
Weber, Marcela C; Jendro, Ashlyn M; Fischer, Ellen P; et al., "Veterans' Experiences of and Preferences for Patient-Centered, Measurement-Based PTSD Care" (2024). Faculty and Staff Publications. 4505.
https://digitalcommons.library.tmc.edu/baylor_docs/4505