Barriers and Potential Solutions to Implementing Evidence-Based PTSD Treatment in Military Treatment Facilities
Year: 2022
Type: article
Abstract: INTRODUCTION: Prolonged exposure therapy is an effective treatment for posttraumatic stress disorder that is underutilized in health systems, including the military health system. Organizational barriers to prolonged exposure implementation have been hypothesized but not systematically examined. This multisite project sought to identify barriers to increasing the use of prolonged exposure across eight military treatment facilities and describe potential solutions to addressing these barriers. MATERIALS AND METHODS: As part of a larger project to increase the use of prolonged exposure therapy in the military health system, we conducted a needs assessment at eight military treatment facilities. The needs assessment included analysis of clinic administrative data and a series of stakeholder interviews with behavioral health clinic providers, leadership, and support staff. Key barriers were matched with potential solutions using a rubric developed for this project. Identified facilitators, barriers, and potential solutions were summarized in a collaboratively developed implementation plan for increasing prolonged exposure therapy tailored to each site. RESULTS: There was a greater than anticipated consistency in the barriers reported by the sites, despite variation in the size and type of facility. The identified barriers were grouped into four categories: time-related barriers, provider-related barriers, barriers related to patient education and matching patients to providers, and scheduling-related barriers. Potential solutions to each barrier are described. CONCLUSIONS: The findings highlight the numerous organizational-level barriers to implementing evidence-based psychotherapy in the military health system and offer potential solutions that may be helpful in addressing the barriers.
Source: Military Medicine
Authors: Carmen P McLean, Jeffrey Cook, David S Riggs, Alan L Peterson, Stacey Young-McCaughan, Elisa V Borah, Katherine Anne Comtois, Katherine A Dondanville, Erin Frick, Christopher K Haddock, Jeffrey Mann, David Reynolds, Melissa Mistretta, Andrea Neitzer, Amy Brzuchalski, Spencer P Clayton, Allison M Conforte, Tyler D DuMars, Kendra Ekundayo, Araceli Flores, Jessica Hein, Jeremy Jinkerson, Felicia Keith, Hana J Kim, Jared S Link, Debra Nofziger, Kirsten Pollick, Erik N Ringdahl, John Waggoner, Craig Woodworth, Craig S Rosen
Institutions: VA Palo Alto Health Care System, Stanford University, Henry M. Jackson Foundation, Uniformed Services University of the Health Sciences, The University of Texas at San Antonio Health Science Center, South Texas Veterans Health Care System, The University of Texas at San Antonio, The University of Texas at Austin, University of Washington, Social Sciences Innovations, William Beaumont Army Medical Center, Holloman Air Force Base, United States Air Force, Blanchfield Army Community Hospital, Brooke Army Medical Center, Keesler Medical Center, Joint Base San Antonio, David Grant USAF Medical Center, Naval Hospital Jacksonville
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,348
Funders: U.S. Department of Defense, U.S. Department of Veterans Affairs, University of Oxford, Uniformed Services University of the Health Sciences, Federal Emergency Management Agency, U.S. Navy, Defense Health Agency, Congressionally Directed Medical Research Programs, Medical Research and Materiel Command, U.S. Army Medical Department
OpenAlex ID: W4292454928