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Clinician Documentation on Receipt of Trauma-Focused Evidence-Based Psychotherapies in a VA PTSD Clinic

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Abstract

The U.S. Department of Veterans Affairs (VA) is implementing two trauma-focused, evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD): cognitive processing therapy and prolonged exposure therapy (PE). Veterans with PTSD often do not receive these treatments, and little is known about the reasons veterans may not receive TF-EBPs. The aim of this qualitative study was to summarize clinician-reported reasons in medical records for nonreceipt of TF-EBPs. All veterans (N = 63) identified through PTSD screening who were newly engaged in mental health care and received individual evaluations in a PTSD specialty clinic in fiscal year 2008 were included in the sample. Content analysis of electronic medical records revealed multiple potential reasons for nonreceipt of TF-EBPs including referral to other PTSD treatments, other clinical priorities, poor engagement in care, practical barriers, negative beliefs, and receipt of care in other settings. Eight veterans (13 %) initiated TF-EBPs. Further interventions to promote engagement in PTSD treatment are warranted.

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Acknowledgments

This work was supported by VA Health Services Research and Development Service (HSR&D) grants REA 06–174 and the Pacific Northwest Mental Illness Research and Education and Clinical Center (MIRECC). The authors acknowledge the PTSD Clinical Team at the Portland VA Medical Center, Jonathan Duckart, Anais Tuepker, Joseph Warren, Molly DeLorit, Brittany Tremblay, Sondra Long, William Minium, and Linda Ganzini. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the U.S. Department of Veterans Affairs or the U.S. government.

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Authors and Affiliations

  1. Mental Health & Clinical Neurosciences Division, Portland VA Medical Center, PO Box 1034, Mail code: P3MHDC, 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA

    Mary W. Lu MD, Jane M. Plagge PsyD, Mary C. Marsiglio MSc & Steven K. Dobscha MD

  2. Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Portland VA Medical Center, 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA

    Steven K. Dobscha MD

Authors
  1. Mary W. Lu MD
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  2. Jane M. Plagge PsyD
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  3. Mary C. Marsiglio MSc
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  4. Steven K. Dobscha MD
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Corresponding author

Correspondence to Mary W. Lu MD.

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Lu, M.W., Plagge, J.M., Marsiglio, M.C. et al. Clinician Documentation on Receipt of Trauma-Focused Evidence-Based Psychotherapies in a VA PTSD Clinic. J Behav Health Serv Res 43, 71–87 (2016). https://doi.org/10.1007/s11414-013-9372-9

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  • DOI: https://doi.org/10.1007/s11414-013-9372-9

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