title: Treatment decision-making for posttraumatic stress disorder: The impact of patient and therapist characteristics.
abstract: The purpose of this study was to assess how patient and provider factors influence the use of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD).
  
  
  
  This study used a 2 × 2 survey design to assess providers' willingness to select EBPs for patients presented in clinical case vignettes. PTSD providers (N = 185) were randomized and asked to respond to 1 of 4 case vignettes in which the patients' age and alcohol use comorbidity were manipulated.
  
  
  
  Results suggested that the majority of providers were favorable toward EBPs, with 49% selecting cognitive processing therapy (CPT) as the first-line intervention, 25% selecting prolonged exposure (PE), and 8% selecting Eye Movement Desensitization Reprocessing therapy. Provider characteristics, but not patient characteristics, influenced treatment selection. Cognitive-behavioral therapy (CBT) orientation, younger age, fewer years of experience, and more time spent treating patients with PTSD were positively related to EBP selection. Provider training in specific EBPs (CPT or PE) increased the likelihood of recommending these treatments as first-line interventions.
  
  
  
  Taken together, these results suggest that providers are increasingly likely to view exposure-based EBPs for PTSD as effective, and that continued dissemination efforts to increase provider familiarity and comfort with these protocols will likely improve rates of EBP use across a variety of practice settings. (PsycINFO Database Record
authors.affiliation: Veterans Affairs South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Hundt
authors.affiliation: VA National Center for PTSD-Executive Division.
authors.forename: Juliette M
authors.initials: JM
authors.lastname: Harik
authors.affiliation: Veterans Affairs South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Terri L
authors.initials: TL
authors.lastname: Barrera
authors.affiliation: Veterans Affairs South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cully
authors.affiliation: Veterans Affairs South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Stanley
mesh_terms: D000328:Adult; D000066491:Clinical Decision-Making; D015928:Cognitive Behavioral Therapy / Q000706:statistics & numerical data*; D055317:Evidence-Based Practice / Q000706:statistics & numerical data*; D057169:Eye Movement Desensitization Reprocessing / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*