Inpatient Trauma-Focused Treatment for Veterans: Implementation and Evaluation of Patient Perceptions and Outcomes of an Integrated Evidence-Based Treatment Approach

摘要

Background: Practice guidelines for post-traumatic stress disorder (PTSD) treatment suggest that inpatient care may be warranted when the severity of the clinical presentation is marred with significant concerns about suicidality and psychiatric comorbidity. Yet, limited guidance exists on conducting trauma-focused treatment in acute hospital settings beyond the traditional medical or stabilization model. Objective: The purpose of this current article is to describe and evaluate the integration of evidence-based treatments (EBTs) for PTSD implemented in two gender-specific, Veterans Affairs inpatient programs. The theoretical underpinnings of these trauma-focused programs are elucidated in this article, and program delivery is explained. The concurrent versus sequential delivery of multiple EBTs over the course of a 30-day, cohorted admission is explained. Results: Paired sample t tests were conducted to determine the effectiveness of these programs on PTSD and depressive symptom severity, and clinically significant reductions in symptoms were found. The characteristics of 584 Veterans (men = 290 and women = 284) who were voluntarily admitted for intensive, trauma-focused work are presented. Treatment completion among the men was 74.8% and 92.4% among the women. Participants' perceptions of treatment acceptability were examined and presented. Conclusions: These preliminary results offer promising evidence for interventions that concurrently provide strategies for increasing coping skills, suicidal disruption, and emotion dysregulation while providing EBTs for PTSD.