Post-Traumatic Stress Disorder
Conditions
Keywords
Posttraumatic Stress Disorder, Social Support, Primary Care
Brief summary
The purpose of the study is to see if Behavioral Activation and Social Engagement for PTSD (BASE for PTSD), an individual therapy for PTSD, will help Veterans with PTSD 1) through improved understanding of how PTSD affects them, 2) by reducing ways in which they avoid meaningful activity due to PTSD, 3) by enabling them to do more of the things they really care about, and 4) by improving, strengthening, and building up their social supports.
Detailed description
Posttraumatic stress disorder (PTSD) is a mental health condition that some people develop following exposure to a traumatic event. PTSD often results in a reduction in feelings of connection to other people and changes in views about others, as well as reduced participation in valued activities. Many veterans with PTSD do not seek treatment offered in specialty mental health settings and may forgo treatment of any kind. This study is an open-trial format (no comparison condition) of U.S. military veterans who will participate in a brief psychotherapy treatment for PTSD offered in a Primary Care setting. This is a pilot trial to see if the treatment is effective at reducing symptoms of PTSD and increasing feelings of social support, and an exploratory aim is to see if veterans engage in additional treatment after completing this treatment.
Interventions
BEHAVIORALBehavioral Activation
Participants will be asked to attend 6 in-person or phone-mediated therapy sessions lasting approximately 45 minutes per session, to be held in Primary Care settings. Content of therapy sessions includes education about PTSD symptoms, discussion of the role of avoidance in maintaining PTSD symptoms, self-monitoring homework to identify links between activity level and emotions, and homework designed to increase engagement in valued activities, with a focus on increasing social contact and support. If relevant, participants will be instructed in basic communication skills, social skills, and relaxation skills.
Sponsors
VA Puget Sound Health Care System
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Veterans who: 1. are currently enrolled in either of the Primary Care Clinics (including Women's Clinic) or Primary Care Mental Health Integration clinic at VA Puget Sound Health Care System - Seattle Division 2. meet criteria for clinical or subclinical PTSD 3. are willing to have therapy sessions audiotaped for the purposes of supervision 4. plan to live in the Seattle area for 6 months following entry into the study
Exclusion criteria
* Veterans who: 1. exhibit the presence of severe mental illness diagnosis (e.g., active psychosis and/or uncontrolled bipolar disorder) 2. have been a psychiatric in-patient admission in the past 30 days 3. have had a suicide attempt in the last 60 days 4. have had a plan or intent to harm self or others in the last 30 days 5. have a behavioral flag in their medical record 6. have had a psychiatric medication dosing or receipt that has changed in the last 30 days 7. are unwilling to provide at least 1 collateral contact 8. have impaired decision making capacity (as measured by evidence in the Computerized Patient Record System record of moderate-severe Traumatic Brain Injury, uncontrolled psychosis, dementia, communication flag, or by clinical judgment in speaking with the participant 9. are prisoners 10. are illiterate or have limited or no English proficiency 11. are terminally ill 12. are currently participating in Cognitive Processing Therapy (CPT) or Prolonged Exposure Therapy (PE)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Behavioral Activation for Depression Scale | baseline to 4 weeks, 4 weeks to 8 weeks, 8 weeks to 12 weeks | Change in activity level |
| PTSD Checklist-Military Version | baseline to 4 weeks, 4 weeks to 8 weeks, 8 weeks to 12 weeks | Change in PTSD symptoms |
| Medical Outcomes Study Social Support Survey Form and Social Connectedness Scale - Revised | baseline to 4 weeks, 4 weeks to 8 weeks, 8 weeks to 12 weeks | Change in social support |
| Patient Health Questionnaire-9 | baseline to 4 weeks, 4 weeks to 8 weeks, 8 weeks to 12 weeks | Change in Depression symptoms |
| Network Orientation Scale | baseline to 4 weeks, 4 weeks to 8 weeks, 8 weeks to 12 weeks | Change in social network orientation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Additional treatment engagement | 16 weeks | measured via medical record review |
| Brief COPE | baseline to 4 weeks, 4 weeks to 8 weeks, 8 weeks to 12 weeks | Change in coping strategies |
| Social Connectedness Scale - Revised (SCS-R) | baseline to 4 weeks, 4 weeks to 8 weeks, 8 weeks to 12 weeks | Change in the level of interpersonal closeness related to participants' social environment and the degree of difficulty experienced by participants in sustaining the sense of closeness |
| Qualitative assessment | 12 weeks | Participants' reactions to the treatment will be gathered in qualitative interviews assessing treatment experience, perceptions of treatment focus, engagement with valued activities, social support, therapeutic relationship |
Countries
United States
Outcome results
None listed