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首页> 外文期刊>Psychological trauma: theory, research, practice and policy >Clinical Treatment Selection for Posttraumatic Stress Disorder: Suggestions for Researchers and Clinical Trainers
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Clinical Treatment Selection for Posttraumatic Stress Disorder: Suggestions for Researchers and Clinical Trainers

机译：术后应激障碍的临床治疗选择：研究人员和临床教练的建议

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Posttraumatic stress disorder (PTSD) disrupts the lives of many Veterans and their families, and multiple treatment options exist. Two evidence-based psychotherapies (EBPs)—cognitive processing therapy (CPT) and prolonged exposure (PE)—are specifically identified by Veterans Affairs (VA) and Department of Defense clinical practice guidelines as first-line treatments. Despite the strong emphasis on training clinicians to provide these EBPs, several questions remain unaddressed. We sought to answer 3 main questions: What associated clinical features are clinicians considering as they select PE or CPT to treat a given patient? What exclusionary criteria are clinicians using? How helpful do clinicians find the extant literature on comorbid conditions and associated clinical features when making treatment decisions? We contacted mental health clinicians who were VA-trained in CPT and PE and requested participation in this online survey. We (a) identified several associated factors that clinicians use to help select between these treatments, (b) determined which associated factors or comorbidities clinicians identified as exclusionary criteria for CPT or PE, and (c) evaluated the perceived utility of research to practicing clinicians. We discuss factors for which clinicians reached a consensus, areas of discrepancy (e.g., substance use), and factors for which further research guidance would be beneficial (e.g., dissociation). Findings imply that VA efforts at disseminating best treatment practices and current PTSD research have been effective. Additionally, findings can help inform treatment guidelines and clinical trainings, as well as highlight gaps in research identified by clinicians.
机译：造创后应力障碍（PTSD）扰乱了许多退伍军人及其家庭的生活，存在多种治疗方案。两种以证据为主的心理治疗（EBPS）认知加工治疗（CPT）和延长的曝光（PE） - 由退伍军人事务（VA）和国防部临床实践指南作为一线治疗。尽管强调培训临床医生提供这些EBP，但几个问题仍未解决。我们试图回答3个主要问题：相关的临床特征是临床医生，考虑到它们选择PE或CPT治疗给定的患者？使用什么排他性标准是临床医生使用？临床医生在制作治疗决策时发现临床医生在合并症条件和相关的临床特征上有多有帮助？我们联系了在CPT和PE培训的心理健康临床医生，并要求参加此在线调查。我们（a）确定了临床医生用来帮助选择这些治疗的几个相关因素，（b）确定了哪些相关因素或临床医生被确定为CPT或PE的排除标准，（c）评估了对练习临床医生的感知实用性。我们讨论临床医生达成共识的因素，差异（例如，物质使用）以及进一步研究指导的因素是有益的（例如，解离）。调查结果暗示传播最佳待遇实践和目前的应急投灾研究的VA努力已经有效。此外，调查结果还可以帮助通知治疗指南和临床培训，并突出临床医生确定的研究中的差距。

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