title: VA Residential Provider Perceptions of Dissuading Factors to the Use of Two Evidence-Based PTSD Treatments.
abstract: Providers (N= 198) from 38 Department of Veterans Affairs residential posttraumatic stress disorder treatment programs across the United States completed qualitative interviews regarding implementation of 2 evidence-based treatments: prolonged exposure and cognitive processing therapy. As part of this investigation, providers were asked how they decide which patients are appropriate for these treatments. Many indicated that they did not perceive any patient factors that dissuade their use of either evidence-based treatment. However, 3 broad categories emerged surrounding reasons that patients were perceived to be less suitable candidates for the treatments: the presence of psychiatric comorbidities, cognitive limitations, and low levels of patient motivation. Interestingly, providers' perceived reasons for limited or nonuse of a treatment did not correspond entirely to those espoused by treatment developers. Possible solutions to address provider concerns, including educational and motivational interventions, are noted.
authors.affiliation: Department of Psychiatry. She has numerous publications in the traumatic stress and geriatric mental health fields, including scientific papers on the phenomenology, assessment and treatment of older adult trauma survivors. She is a member of the American Psychological Association's Guideline Development Panel for PTSD. Yale School of Medicine and National Center for PTSD, West Haven, Connecticut.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Cook
authors.affiliation: Her research interests include trauma and posttraumatic stress disorder in older adult populations. Yale School of Medicine and National Center for PTSD, West Haven, Connecticut.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dinnen
authors.affiliation: She is affiliated with Yale University and her interests are evidence based care for posttraumatic stress disorder and dissemination and implementation research. Yale School of Medicine and National Center for PTSD, West Haven, Connecticut.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Simiola
authors.affiliation: His major areas of interest are the effects of trauma on psychological functioning, and access to mental health care. University of Illinois at Chicago.
authors.forename: Richard
authors.initials: R
authors.lastname: Thompson
authors.affiliation: She is research professor of psychiatry at the Geisel School of Medicine at Dartmouth and editor of the Clinician's Trauma Update-Online . Her research focuses on the treatment of PTSD and risk and resilience factors associated with response to traumatic events. National Center for PTSD, White River Junction, Vermont and Geisel School of Medicine at Dartmouth College.
authors.forename: Paula P
authors.initials: PP
authors.lastname: Schnurr
keywords: evidence-based treatment; posttraumatic stress disorder; provider perspectives