Psychotherapy Utilization, Preferences, and Retention among Women Veterans with Post-traumatic Stress Disorder

被引:5
作者
Farmer, Courtney C. [1 ]
Rossi, Fernanda S. [2 ,3 ,4 ]
Michael, Elizabeth M. [1 ]
Kimerling, Rachel [2 ,5 ]
机构
[1] Palo Alto Univ, PGSP Stanford PsyD Consortium, Palo Alto, CA USA
[2] VA Palo Alto Hlth Care Syst, Ctr Innovat Implementat, Menlo Pk, CA 94025 USA
[3] Stanford Univ, Sch Med, Ctr Primary Care & Outcomes Res, Palo Alto, CA 94304 USA
[4] Stanford Univ, Sch Med, Ctr Hlth Policy, Palo Alto, CA 94304 USA
[5] VA Palo Alto Hlth Care Syst, Natl Ctr PTSD, Menlo Pk, CA 94025 USA
关键词
MENTAL-HEALTH-CARE; ADVERSE CHILDHOOD EXPERIENCES; PTSD; IRAQ; PHARMACOTHERAPY; SYMPTOMS; SERVICES; EXPOSURE; DROPOUT; ACCESS;
D O I
10.1016/j.whi.2020.06.003
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Psychotherapy is the gold standard treatment for post-traumatic stress disorder (PTSD), yet psychotherapy use and retention among veterans is low. Little is known about the barriers to care and factors associated with women veterans' PTSD psychotherapy use and retention. Using a nationally representative sample of 986 women Veterans Health Administration primary care users with PTSD and a perceived need for mental health care, we examined 1) the proportion of women who used psychotherapy, 2) retention in psychotherapy among women who used any psychotherapy, and 3) individual factors related to psychotherapy use and retention. Methods: Women completed a survey on their mental health care experiences. Outpatient mental health care use in the year before the survey was obtained from Veterans Health Administration administrative data. Results: Most women (79.1%) used psychotherapy, and 41.7% of those women had a minimal therapeutic dose of psychotherapy (>8 visits). Mental health diagnostic comorbidity and being African American/Black or identifying as neither African American/Black nor White were significantly associated with higher psychotherapy use. Mental health diagnostic comorbidity, exposure to military sexual trauma, and receiving treatment aligned with gender-related and grouprelated preferences were associated with higher psychotherapy retention. Being a parent was associated with lower retention. Conclusions: Although a significant proportion of women veterans with PTSD are using psychotherapy, retention is enhanced when women are able to obtain treatment aligned with their preferences. Thus, efforts to promote patientcentered, shared decisions regarding mental health treatment options could increase the efficacy and efficiency of treatment for PTSD among women. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.
引用
收藏
页码:366 / 373
页数:8
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