“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 Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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