Overcoming Barriers to the Delivery of Evidence Based PTSD Treatment

“While outcome research points to trauma-focused interventions, particularly exposure therapy, as the most effective form of treatment for posttraumatic stress, several practitioner surveys have indicated that most do not use this approach,” said Anne-Laure Couineau and David Forbes of the Australian Centre for Posttraumatic Mental Health and the University of Melbourne. They noted, however, that some programs, like the Improving Access to Psychological Therapies (IAPT) program in the U.K. are being implemented and providing promising results. “Pilot studies from the IAPT project reported that 55–56% of clients had recovered and had, to a great extent, maintained their health status at 10 months,” said the team. Regardless of the fact that therapies that exposure strategies appear to work well for PTSD, many practitioners do not implement them because of the perceived barriers such as adoption of clinical procedures and organizational culture.

In an attempt to encourage the use of this type of therapy, Couineau and Forbes provided the IAPT training to 34 clinicians who treat posttraumatic stress. The clinicians completed questionnaires regarding the perceived barriers to trauma-focused interventions three months before they received the training and again 8 months after it was implemented. They filled out records for each new client with PTSD prior to the training and again at three and six months post-training.

The attitudes of the clinicians had shifted dramatically as a result of receiving the training, with all of the participants believing that exposure therapy would work at conclusion. “There was also a statistically significant shift in thinking among participants who hadn’t used a trauma-focused approach because it ‘doesn’t fit with the Model I use when providing counseling’; only 6% of participants felt this way in the final survey as compared to 29% in the initial survey.” Additionally, imaginal exposure, a proven effective technique, was implemented at an increase of 17% after training. The team added, “In summary, this study demonstrated a systematic approach to identifying and addressing individual and organizational barriers associated with the uptake of evidence-based trauma-focused treatment for PTSD.”

Couineau, A.-L., & Forbes, D. (2011, August 29). Using Predictive Models of Behavior Change to Promote Evidence-Based Treatment for PTSD. Psychological Trauma: Theory, Research, Practice, and Policy.  Advance online publication. doi: 10.1037/a0024980

© Copyright 2011 by By John Smith. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • ella

    September 12th, 2011 at 3:55 PM

    It is hard to change the midset of practitioners who have always done the same thing for years and years. But if different appraoches are showing this kind of success then those who are good are bound to wnat to try to implement this treatment with their patients too.

  • gresham

    September 12th, 2011 at 7:19 PM

    it is always better that a practitioner knows two or more therapy methods.well I understand that some may specialize in a particular method but it is always better to have practice in some others as well. what this does is it let’s the practitioner study the particular case and decide as to which therapy may suit the case the best.it will then directly reflect on the level of success for the patient.

  • lauren d

    September 13th, 2011 at 4:20 AM

    The bad thing is that the barrier here is human created and due to the stubborn bent of some others are not getting the care that could help them thrive again. I do not think that I would ever let being so hard headed interfere with giving someone something that could help them to improve.

  • JOE

    September 13th, 2011 at 7:26 AM

    Some professions can go on with the little knowledge that a person received before work and can continue to work with that same knowledge.But professions such as these simply cannot.

    They are always going to be newer methods and treatments,newer developments in the field and so on.The professionals will need to keep up with the newer stuff and even incorporate the appropriate developments into their own work.only then can the end user,the patients in this case,will get the best service.

  • Kyle N

    September 13th, 2011 at 3:24 PM

    Therapy isn’t the kind of career where you can learn it once and continue doing it that way for the rest of you career. Instead it’s evolving and improving faster than anyone can Imagine and therapist should be aware of these improvements in order to make informed decisions based on their clients best interest to whether or not they should implement these new methods. I think that therapists who aren’t ready to change to trauma focused interventions are most likely the ones who have been doing it a certain way for so long that they don’t want to now switch to a method that they have yet to see work with their own eyes.

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