Monday, June 16, 2014

Brief Telephone Intervention Using CBT Can Prompt Vets to Reconsider PTSD Treatment

A one-time brief telephone intervention appears to be effective in engaging service members in PTSD treatment earlier than conventional methods and may lead to immediate symptom reduction, according to a report, "RCT of a Brief Phone-Based CBT Intervention to Improve PTSD Treatment Utilization by Returning Service Members," published in Psychiatric Services in Advance.

Researchers at White River Junction Veterans Affairs Medical Center and Dartmouth Medical School randomly assigned 300 service members who had served in Operation Enduring Freedom or Operation Iraqi Freedom and screened positive for PTSD but had not engaged in PTSD treatment to either a brief cognitive-behavioral therapy (CBT) intervention or to usual care. The intervention session was administered by telephone by a psychologist and lasted about 45 to 60 minutes. The sessions were based on CBT principles and focused on modifying thoughts about receiving treatment for PTSD symptoms. For example, the thought “I don’t need treatment” might become “I might need treatment, considering how hard it is to sleep and the impact it is having on my relationships and job.” Participants identified individual beliefs about treatment during the intervention session, and the intervention session addressed a maximum of three beliefs with each participant.

All participants received follow-up phone calls at months 1, 3, and 6 to assess symptoms and service utilization. Participants in both conditions had comparable rates of treatment engagement and PTSD symptom reduction over the course of the six-month trial, but receiving the telephone-based intervention accelerated service utilization (treatment engagement and number of sessions) and PTSD symptom reduction.

“There were no differences at the longer-term follow-up, suggesting the need for additional intervention to build on initial gains. Additional intervention could include a booster session that occurs at two weeks or one month subsequent to the initial intervention session. This additional session could bolster the individual’s intention to seek or to stay in PTSD treatment and would allow for continued use of coping skills or even allow service members to continue to explore the meaning of the trauma experienced.”

To read more about this subject, see the Psychiatric News article, "Expectations Deter Vets From Seeking Mental Health Care."

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