VA Practice Patterns and Practice Guidelines for Treating Posttraumatic Stress Disorder

Authors: Rosen C.S.¹; Chow H.C.²; Finney J.F.²; Greenbaum M.A.²; Moos R.H.³; Sheikh J.I.⁴; Yesavage J.A.⁵

Source: Journal of Traumatic Stress, Volume 17, Number 3, June 2004 , pp. 213-222(10)

Publisher: Springer

Abstract:

Little is known about how recent ISTSS practice guidelines (E. B. Foa, T. M. Keane, & M. J. Friedman, 2000) compare with prevailing PTSD treatment practices for veterans. Prior to guideline dissemination, clinicians in 6 VA medical centers were surveyed in 1999 (n = 321) and in 2001 (n = 271) regarding their use of various assessment and treatment procedures. Practices most consistent with guideline recommendations included psychoeducation, coping skills training, attention to trust issues, depression and substance use screening, and prescribing of SSRIs, anticonvulsants, and trazodone. PTSD and trauma assessment, anger management, and sleep hygiene practices were provided less consistently. Exposure therapy was rarely used. Additional research is needed on training, clinical resources, and organizational factors that may influence VA implementation of guideline recommendations.

Keywords: posttraumatic stress disorder; veterans; practice guidelines; translational research

Document Type: Research article

DOI: http://dx.doi.org/10.1023/B:JOTS.0000029264.23878.53

Affiliations: 1: National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. VA VISN 21 Mental Illness Research, Education, and Clinical Center, Palo Alto, California. Stanford/VA Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California;, Email: crosen@stanford.edu 2: VA VISN 21 Mental Illness Research, Education, and Clinical Center, Palo Alto, California. Stanford/VA Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California 3: VA VISN 21 Mental Illness Research, Education, and Clinical Center, Palo Alto, California. Stanford/VA Center for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, California. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California 4: National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. VA VISN 21 Mental Illness Research, Education, and Clinical Center, Palo Alto, California. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California 5: VA VISN 21 Mental Illness Research, Education, and Clinical Center, Palo Alto, California. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

Publication date: 2004-06-01

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