title: Use of evidence-based treatment for posttraumatic stress disorder in Army behavioral healthcare.
abstract: OBJECTIVE
  To identify the extent to which evidence-based psychotherapy (EBP) and psychopharmacologic treatments for posttraumatic stress disorder (PTSD) are provided to U.S. service members in routine practice, and the degree to which they are consistent with evidence-based treatment guidelines.
  
  
  METHODS
  We surveyed the majority of Army behavioral health providers (n = 2,310); surveys were obtained from 543 (26%). These clinicians reported clinical data on a total sample of 399 service member patients. Of these patients, 110 (28%) had a reported PTSD diagnosis. Data were weighted to account for sampling design and nonresponses.
  
  
  RESULTS
  Army providers reported 86% of patients with PTSD received evidence-based psychotherapy (EBP) for PTSD. As formal training hours in EBPs increased, reported use of EBPs significantly increased. Although EBPs for PTSD were reported to be widely used, clinicians who deliver EBP frequently reported not adhering to all core procedures recommended in treatment manuals; less than half reported using all the manualized core EBP techniques.
  
  
  CONCLUSIONS
  Further research is necessary to understand why clinicians modify EBP treatments, and what impact this has on treatment outcomes. More data regarding the implications for treatment effectiveness and the role of clinical context, patient preferences, and clinical decision-making in adapting EBPs could help inform training efforts and the ways that these treatments may be better adapted for the military.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Wilk
authors.forename: Joyce C
authors.initials: JC
authors.lastname: West
authors.forename: Farifteh F
authors.initials: FF
authors.lastname: Duffy
authors.forename: Richard K
authors.initials: RK
authors.lastname: Herrell
authors.forename: Donald S
authors.initials: DS
authors.lastname: Rae
authors.forename: Charles W
authors.initials: CW
authors.lastname: Hoge
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D057286:Electronic Health Records; D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D008890:Military Psychiatry / Q000592:standards / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D014481:United States; D055815:Young Adult