title: The influence of patient readiness on implementation of evidence-based PTSD treatments in Veterans Affairs residential programs.
abstract: OBJECTIVE
  Mental health provider perceptions of patient readiness for trauma-focused evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) have been found to impact outpatient care in the Department of Veterans Affairs (VA).
  
  
  METHODS
  One hundred and 72 mental health directors and providers from 36 VA residential PTSD treatment programs completed qualitative interviews regarding implementation of two EBTs, Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT). Perceptions of patients' "readiness" for PE and CPT, including how to define and assess this construct and how it influences implementation of these EBTs, were discussed.
  
  
  RESULTS
  Patient readiness was identified as having three components: psychological and psychiatric stability, general readiness to change, and specific skills to manage trauma-focused EBTs (e.g., distress tolerance, affect regulation skills). Providers indicated that some patients who are deemed not ready are either screened out prior to entry or helped to get ready prior to or during their residential stay. Providers expressed difficulties predicting who is actually ready and described what they saw as differences between readiness for PE as compared with CPT.
  
  
  CONCLUSIONS
  The concept of readiness for trauma-focused EBTs impacted admission and access to services in the programs. Future research directions, such as empirically measuring readiness and formally assessing veterans' perceptions of and willingness to participate in these EBTs, are considered. (PsycINFO Database Record
authors.affiliation: Department of Psychiatry, Yale School of Medicine.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Cook
authors.affiliation: Department of Psychiatry, Yale School of Medicine.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Simiola
authors.affiliation: Executive Division, National Center for PTSD.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hamblen
authors.affiliation: Executive Division, National Center for PTSD.
authors.forename: Nancy
authors.initials: N
authors.lastname: Bernardy
authors.affiliation: Executive Division, National Center for PTSD.
authors.forename: Paula P
authors.initials: PP
authors.lastname: Schnurr
mesh_terms: D003071:Cognition; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D056348:Emotional Intelligence; D055317:Evidence-Based Practice; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007171:Implosive Therapy; D007407:Interviews as Topic; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D012114:Residential Treatment; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*; D054063:Superior Sagittal Sinus; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*