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Symposia
Treatment - CBT
Princess E. Ackland, M.P.H., Ph.D.
Clinical Psychologist
Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System/University Of Minnesota
Minneapolis, Minnesota, United States
Shannon Kehle-Forbes, PhD
Psychologist
Minneapolis VA Health Care System
Minneapolis, Minnesota, United States
Erin Linden, MPH
Project Manager
Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System
Minneapolis, Minnesota, United States
Emily Campbell, MA
Research Coordinator
Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System
Minneapolis, Minnesota, United States
Robert Orazem, PhD
Research Coordinator
Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System
Minneapolis, Minnesota, United States
Michele Spoont, PhD
COIN Investigator
Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System
Minneapolis, Minnesota, United States
Melissa Polusny, PhD LP
Staff Psychologist, Professor
Minneapolis VA/University of Minnesota
Minneapolis, Minnesota, United States
David Nelson, PhD
COIN Investigator
Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System
Minneapolis, Minnesota, United States
Carl Isenhart, PhD
Staff Psychologist
VA Desert Pacific Healthcare Network (VISN 22)
Long Beach, California, United States
Afsoon Eftekhari, PhD
Psychologist
National Center For PTSD
Menlo Park, California, United States
Millie Astin, Ph.D.
Psychologist
ATL VAHCS
Atlanta, Georgia, United States
Katherine Porter, PhD
Staff Psychologist
VA Ann Arbor Healthcare System
Ann Arbor, Michigan, United States
Erin Smith, PhD
Staff Psychologist
VA Ann Arbor Healthcare System
Ann Arbor, Michigan, United States
.jpg "Shirley Glynn, Ph.D. (she/her/hers) photo")
Shirley Glynn, Ph.D. (she/her/hers)
Research Psychologist
VA/UCLA
Los Angeles, California, United States
Dropout from Prolonged Exposure (PE) and its trauma-focused counterpart Cognitive Processing Therapy reportedly exceeds 60% (Hale et al., 2019; Maguen et al., 2019). Our prior work has shown that a loved one’s encouragement to face distress can improve PTSD treatment adherence (Meis et al, 2019). However, PTSD psychotherapies such as PE while very effective, do not formally incorporate family. Family-Supported PE (FSPE) involves standard PE with the integration of family collaboration in the treatment through additional therapy components. Sessions are 1.5 to 2-hours over 8 to 15 sessions (Meis et al., 2022) with longer sessions concentrated toward the beginning of therapy. As part of a hybrid 1 trial testing the effectiveness of FSPE versus standard PE on treatment adherence, we interviewed 13 study therapists and 7 mental health leaders from the three VA study facilities about their experience with FSPE and potential influences on real-world implementation. Interviews were 30-60 minutes, recorded, transcribed, and analyzed using a rapid-turn around analytic approach. Initial analyses uncovered that therapists believed family inclusion was “a really nice idea,” appreciated that FSPE formalized the family role and facilitated joint learning, and intended to use FSPE in some form in the future. Leaders were open to adopting FSPE in their clinics if the data supported its effectiveness. Main challenges were the 2-hour session length, managing two people in the room and working with their schedules, and “juggling” FSPE components (e.g., motivational interviewing). Real-world implementation may require extending the number of sessions to reduce session length, providing therapists more couples/systemic therapy training, particularly methods for managing challenging dyads, and offering system-level support for FSPE delivery (e.g., evening appointments, virtual care). Findings suggest that buy-in for family involvement in PE exists in the field, but modifications to FSPE components may be needed for widespread integration.