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Evaluation ViewAttendees 3

Treatment - CBT
Symposia

Symposium 91 - Family Member Support for Psychotherapy for PTSD: A Promising Innovation for Treatment Engagement

Saturday, November 16, 2024
2:30 PM – 4:00 PM EST
Location: Grand Ballroom D, Level 5, Downtown Marriott
CE: 1.5

Keywords: PTSD (Posttraumatic Stress Disorder), Implementation, Veterans
Level of Familiarity: Moderate
Recommended Readings: Meis, L. A., Glynn, S. M., Spoont, M. R., Kehle-Forbes, S. M., Nelson, D., Isenhart, C. E., Eftekhari, A., Ackland, P. E., Linden, E. B., Orazem, R. J., Cutting, A.,
Hagel Campbell, E. M., Astin, M. C., Porter, K. E., Smith, E., Chuick, C. D., Lamp, K. E., Vuper, T. C., Oakley, T. A., Polusny, M. A. (2022). Can families
help veterans get more from PTSD treatment? A randomized clinical trial examining Prolonged Exposure with and without family involvement.
Trials, 23(1), 243. https://doi.org/10.1186/s13063-022-06183-2,  

Shepherd-Banigan, M., Wells, S. Y., Falkovic, M., Ackland, P. E., Swinkels, C., Dedert, E., Ruffin, R., Van Houtven, C. H., Calhoun P. S., Edelman, D., Weidenbacher, H. J., Shapiro, A., & Glynn, S. (2022). Adapting a family-involved intervention to increase initiation and completion of evidenced-based psychotherapy for posttraumatic stress disorder. SSM - Mental Health, https://doi.org/10.1016/j.ssmmh.2022.100114

,  

Thompson-Hollands, J., Lee, D. J., & Sloan, D. M. (2021). The Use of a Brief Family Intervention to Reduce Dropout Among in 
             Individual Trauma-Focused Treatment: A Randomized Controlled Trial. Journal of Traumatic Stress, 34(4), 829-839.   
             https://doi.org/10.1002/jts.22680\

,   ,  

Posttraumatic stress disorder (PTSD) and its sequelae is an inherently social experience (Maercker & Horn, 2013). PTSD can have profound adverse implications for domains of life requiring a high degree of interpersonal interaction, including social relationships, work, and community participation. On the other hand, for individuals who develop PTSD, positive social support can improve PTSD therapy outcomes (Spoont et al., 2014). For example, family encouragement to seek PTSD therapy is associated with a greater odds of treatment use (Spoont et al., 2014). And, Veterans beginning a course of PE or CPT are two times more likely to remain in therapy if a loved one encouraged them to face situations that made them feel anxious (Meis et al., 2019). Decisions to begin treatment are not only motivated by a desire to improve relationships with loved ones, but are often made together with a family member (Shepherd-Banigan et al., 2023). Family engagement in treatment is also desired by Veterans (Cohen et al., 2013; Khaylis et al., 2011; Thompson-Hollands et al., 2022). The way in which PTSD symptoms impact and are affected by reactions in the family unit suggests that treatment for PTSD should at least offer opportunities for family-involved approaches. Yet, despite decades of calls for systematic inclusion of family in PTSD treatment (American Psychological Association, 2007; Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder & Institute of Medicine, 2012; Harper et al., 2022; U.S. Congress, 2006), implementation of family-involved interventions remains limited in healthcare systems.

Veterans Health Administration (VHA), uptake of highly effective evidenced-based therapies (EBP) for PTSD, is low (Maguen et al., 2020). Involving a support partner (SP), who could be a family member or another close companion, in the treatment process is a promising innovation to increase treatment uptake (Monson et al., 2024). Yet, only in the last few years have family-based approaches been developed to increase engagement in EBPs (Meis et al., 2022; Shepherd-Banigan et al., 2022; Thompson-Hollands et al., 2021). Some barriers include limited provider training in couples therapy approaches, unhelpful family dynamics, limited staff resources, lack of support from leadership, and perceptions that family approaches were less effective than individual approaches (Shepherd-Banigan et al., 2024; Thompson-Hollands et al., 2022)
This symposium presents four distinct approaches to family-involvement to for EBP uptake: Family Supported PE, Partner-Assisted PE, Brief Family Intervention, and FAMILIAR. Furthermore, we advance the awareness that family-supported interventions for PTSD EBPs are an important innovation for health systems to address low use of EBPs and that they are acceptable and feasible from the perspectives of patients, SPs, and clinicians.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Propose family-involved interventions as an innovation in PTSD care and treatment to increase uptake of EBPs for PTSD.
  2. Describe four distinct family-involved approaches to increase uptake of EBPs for PTSD.
  3. Present data from patients, SPs, and clinicians about the feasibility and acceptability of family-based approaches.
  4. Discuss issues related to implementation of family-involved interventions.
  5. Discuss implications of family-involved interventions for clinical practice.

Presentations:

  • 2:30 PM – 4:00 PM EST
    (SYM 91) A Pilot Study of a Couples Approach to Prolonged Exposure for PTSD

    Speaker: Laura Meis, Ph.D. (she/her/hers) – National Center for PTSD, Center for Care Delivery & Outcomes Research, Minneapolis VA

    Co-author: Afsoon Eftekhari, PhD – National Center For PTSD

    Co-author: Shannon Kehle-Forbes, PhD – Minneapolis VA Health Care System

    Co-author: Christopher Chuick, PhD – Minneapolis VA Healthcare System

    Co-author: Christie King, PhD – Minneapolis VA Healthcare System

    Co-author: Jenna Robison-Andrew, PhD, – Minneapolis VA Healthcare System

    Co-author: Erin Linden, MPH – Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System

    Co-author: Emily Campbell, MA – Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System

    Co-author: Shirley Glynn, Ph.D. (she/her/hers) – VA/UCLA

  • 2:30 PM – 4:00 PM EST
    (SYM 91) An Adjunctive Family Intervention for PTSD: Addressing Family Member Goals for Involvement in PTSD Treatment

    Speaker: Johanna Thompson-Hollands, Ph.D. (she/her/hers) – National Center for PTSD

    Co-author: Zackary Mullins, BA – Cincinnati VAMC– Ft. Thomas Division

    Co-author: Stephanie Trendel, BA – National Center For PTSD At VA Boston Healthcare System

    Co-author: Sarah Stoycos, PhD – Keck School Of Medicine

    Co-author: Nicole Pukay-Martin, PhD – Durham VA Health Care System

    Co-author: Eileen Barden, PhD – National Center For PTSD At VA Boston Healthcare System

    Co-author: Michelle Fernando, PhD – National Center for PTSD at VA Boston Healthcare System

  • 2:30 PM – 4:00 PM EST
    (SYM 91) Family-involved Interventions May Offer Unique Benefits for Veterans with PTSD Experiencing High Family Strain

    Speaker: Megan Shepherd-Banigan, Ph.D. (she/her/hers) – Durham VA

    Co-author: Hope Salameh, BA – Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System,

    Co-author: Abigail Shapiro, MPH – Durham VA Health Care System

    Co-author: Karen Stechuchak, MS – Durham VA Health Care System

    Co-author: Stephanie Wells, PhD – Durham VA Health Care System

    Co-author: Joseph Neiman, MD – Durham VA Health Care System

    Co-author: Hollis Weidenbacher, PhD – Durham VA Health Care System

    Co-author: Madeleine Eldridge, MPH – Durham VA Health Care System

    Co-author: Tiera Lanford, MPH – Durham VA Health Care System

    Co-author: Barbara Bokhour, PhD – Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School

    Co-author: Shirley Glynn, Ph.D. (she/her/hers) – VA/UCLA

    Co-author: Rachel Ruffin, PhD – Durham VA Health Care System

    Co-author: Courtney Van Houtven, PhD – Durham VA Health Care System

    Co-author: David Edelman, MD – Durham VA Health Care System

    Co-author: Patrick Calhoun, PhD – Durham VA Health Care System

    Co-author: Cindy Swinkels, Ph.D. (she/her/hers) – VISN 6 MIRECC

    Co-author: Eric Dedert, PhD – Durham VA Health Care System

    Co-author: Princess E. Ackland, M.P.H., Ph.D. – Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System/University Of Minnesota

  • 2:30 PM – 4:00 PM EST
    (SYM 91) Family-supported PE: What Would It Take for Real-world Implementation?

    Speaker: Princess E. Ackland, M.P.H., Ph.D. – Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System/University Of Minnesota

    Co-author: Shannon Kehle-Forbes, PhD – Minneapolis VA Health Care System

    Co-author: Erin Linden, MPH – Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System

    Co-author: Emily Campbell, MA – Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System

    Co-author: Robert Orazem, PhD – Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System

    Co-author: Michele Spoont, PhD – Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System

    Co-author: Melissa Polusny, PhD LP – Minneapolis VA/University of Minnesota

    Co-author: David Nelson, PhD – Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System

    Co-author: Carl Isenhart, PhD – VA Desert Pacific Healthcare Network (VISN 22)

    Co-author: Afsoon Eftekhari, PhD – National Center For PTSD

    Co-author: Millie Astin, Ph.D. – ATL VAHCS

    Co-author: Katherine Porter, PhD – VA Ann Arbor Healthcare System

    Co-author: Erin Smith, PhD – VA Ann Arbor Healthcare System

    Co-author: Shirley Glynn, Ph.D. (she/her/hers) – VA/UCLA