title: Cognitive processing therapy for veterans with posttraumatic stress disorder: a comparison between outpatient and residential treatment.
abstract: OBJECTIVE
  Across the Veterans Affairs (VA) Healthcare System, outpatient and residential posttraumatic stress disorder (PTSD) treatment programs are available to veterans of all ages and both genders; however, no research to date has compared these treatment options. This study compared veterans who received outpatient (n = 514) to those who received residential treatment (n = 478) within a VA specialty clinic on demographic and pretreatment symptom variables. Further, the study examined pre- to posttreatment symptom trajectories across the treatment programs.
  
  
  METHODS
  All 992 veterans met diagnostic criteria for PTSD and attended at least 1 session of cognitive processing therapy (CPT) in either the outpatient or residential program. Bivariate analyses were utilized to investigate differences between samples on demographic variables and severity of pretreatment symptoms. Multilevel modeling (MLM) was used to investigate the change in symptomatology between the 2 samples from pre- to posttreatment.
  
  
  RESULTS
  Analyses indicated that the samples differed on all demographic and pretreatment symptom variables, with residential patients reporting higher scores on all assessment measures. MLM results demonstrated that symptom scores improved for all veterans across time, with outpatients consistently reporting fewer symptoms at both time points. The time by program interaction was significant for PTSD-related symptom trajectories, but not for the depression-related symptom trajectory.
  
  
  CONCLUSIONS
  This is the 1st study to compare pretreatment characteristics and treatment outcome between veterans receiving outpatient and residential PTSD treatment. Findings may help clinicians select appropriate care for their patients by identifying relevant pretreatment characteristics and generally informing expectations of treatment outcome.
authors.affiliation: Health Services Research & Development, Veterans Medical Research Foundation.
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Walter
authors.affiliation: PTSD Outpatient Clinic, Veterans Affairs Puget Sound Health Care System, American Lake Division.
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Varkovitzky
authors.affiliation: Department of Psychology, University of Tennesse-Knoxville.
authors.forename: Gina P
authors.initials: GP
authors.lastname: Owens
authors.affiliation: Trauma Recovery Center, Cincinnati Veterans Affairs Medical Center.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lewis
authors.affiliation: Trauma Recovery Center, Cincinnati Veterans Affairs Medical Center.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Chard
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012114:Residential Treatment; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000523:psychology