VA practice patterns and practice guidelines for treating posttraumatic stress disorder.
Little is known about how recent ISTSS practice guidelines (E. B. Foa, T. M. Keane, & M. J. Friedman, 2000) compare with prevailing PTSD treatment practices for veterans. Prior to guideline dissemination, clinicians in 6 VA medical centers were surveyed in 1999 (n = 321) and in 2001 (n = 271) regarding their use of various assessment and treatment procedures. Practices most consistent with guideline recommendations included psychoeducation, coping skills training, attention to trust issues, depression and substance use screening, and prescribing of SSRIs, anticonvulsants, and trazodone. PTSD and trauma assessment, anger management, and sleep hygiene practices were provided less consistently. Exposure therapy was rarely used. Additional research is needed on training, clinical resources, and organizational factors that may influence VA implementation of guideline recommendations.
Rosen
Craig S
CS
National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA. crosen@stanford.edu
Chow
Helen C
HC
Finney
John F
JF
Greenbaum
Mark A
MA
Moos
Rudolf H
RH
Sheikh
Javaid I
JI
Yesavage
Jerome A
JA
D003863:Depression; D019983:Guideline Adherence; D019538:Health Care Surveys; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008403:Mass Screening; D008511:Medicine; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012890:Sleep; D013038:Specialization; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D014728:Veterans / Q000523:psychology*