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Cited by 88Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsTraumatic Brain Injury Research

Sticking it out in trauma-focused treatment for PTSD: It takes a village.

Open access
Meis, Laura A., Noorbaloochi, Siamak, Hagel Campbell, Emily M., Erbes, Christopher R., Polusny, Melissa A., Velasquez, Tina L., Bangerter, Ann, Cutting, Andrea +5 more·2019·Journal of Consulting and Clinical Psychology
DOI 10.1037/ccp0000386PMC PMC6548182
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Abstract

OBJECTIVE: One in 3 veterans will dropout from trauma-focused treatments for posttraumatic stress disorder (PTSD). Social environments may be particularly important to influencing treatment retention. We examined the role of 2 support system factors in predicting treatment dropout: social control (direct efforts by loved ones to encourage veterans to participate in treatment and face distress) and symptom accommodation (changes in loved ones' behavior to reduce veterans' PTSD-related distress). METHOD: Veterans and a loved one were surveyed across 4 VA hospitals. All veterans were initiating prolonged exposure therapy or cognitive processing therapy (n = 272 dyads). Dropout was coded through review of VA hospital records. RESULTS: Regression analyses controlled for traditional, individual-focused factors likely to influence treatment dropout. We found that, even after accounting for these factors, veterans who reported their loved ones encouraged them to face distress were twice as likely to remain in PTSD treatment than veterans who denied such encouragement. CONCLUSIONS: Clinicians initiating trauma-focused treatments with veterans should routinely assess how open veterans' support systems are to encouraging veterans to face their distress. Outreach to support networks is warranted to ensure loved ones back the underlying philosophy of trauma-focused treatments. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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  • Encouragement to face distress from close others increased the likelihood of treatment adherence, particularly within the context of low-strain relationships.

    “Similarly, Meis et al. (2019) found that encouragement to face distress from close others increased the likelihood of treatment adherence, particularly within the context of low-strain relationships.”

    From Feeling pressured to talk about trauma: How pressure to disclose alters the association between trauma disclosure and posttraumatic growth (2023) · cites this paper as Meis et al., 2019

    The Results (Primary analyses) report that veterans whose loved ones encouraged them to face distress were more likely to complete trauma-focused treatment. Follow-up analyses found the strongest association in low-strain relationships, but the interaction with relationship strain only approached significance (p = .091); the Discussion cautions that conclusions cannot be drawn from those analyses. The claim presents the low-strain qualification more firmly than the paper does. (LLM, conf=0.86)

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Research works printed but not linked: 3

  1. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR). Washington, DC: Author.
  2. Duncan BL, Miller SD, Sparks J, Claud DA, Reynolds LR, Brown J, & Johnson LD (2003). The session rating scale: Preliminary psychometric properties of a “working” alliance measure. Journal of Brief Therapy, 3, 3– 12.
  3. Institute of Medicine. (2007). Treatment of posttraumatic stress disorder: An assessment of the evidence. Washington, DC: The National Academies Press.

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Authors
Meis, L. A., Noorbaloochi, S., Hagel Campbell, E. M., Erbes, C. R., Polusny, M. A., Velasquez, T. L., Bangerter, A., Cutting, A., Eftekhari, A., Rosen, C. S., Tuerk, P. W., Burmeister, L. B., & Spoont, M. R.
Affiliations
  • Minneapolis VA Health Care System (US)
  • VA Palo Alto Health Care System (US)
  • University of Virginia (US)
  • Phoenix VA Health Care System (US)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2019-03
Volume
87
Issue
3
Pages
246-256
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/ccp0000386
PMC
PMC6548182
OpenAlex
W2916310854
Cited by
88
References
66
Citations by year
2026: 6 · 2025: 5 · 2024: 19 · 2023: 13 · 2022: 15 · 2021: 10 · 2020: 10 · 2019: 9 · 2018: 1
FWCI
12.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Department of Defense’s Congressionally Directed Medical Research Program (W81XWH-12-1-0619)
  • Department of Veterans Affairs (HSR&D CDA 10-035; RRP 12-229)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
post-traumatic stress disorder, treatment discontinuation, treatment retention, trauma-focused psychotherapy, prolonged exposure therapy, cognitive processing therapy, social control, social support, veterans, family involvement
MeSH terms
Adult, Female, Humans, Implosive Therapy, Male, Middle Aged, Patient Dropouts, Surveys and Questionnaires, Social Environment, Stress Disorders, Post-Traumatic, Veterans, Cognitive Behavioral Therapy

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