VA practice patterns and practice guidelines for treating posttraumatic stress disorder

• Published in: Journal of traumatic stress Vol. 17; no. 3; pp. 213 - 222
• Main Authors: Rosen, Craig S., Chow, Helen C., Finney, John F., Greenbaum, Mark A., Moos, Rudolf H., Sheikh, Javaid I., Yesavage, Jerome A.
• Format: Journal Article
• Language: English
• Published: Germantown Periodicals Service Company 01.06.2004; Wiley; Wiley Subscription Services, Inc
• Subjects: Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Biological and medical sciences; Depression; Guideline Adherence; Health Care Surveys; Hospitals, Veterans - statistics & numerical data; Humans; Mass Screening; Medical sciences; Medicine; Post-traumatic stress disorder; posttraumatic stress disorder; practice guidelines; Practice Guidelines as Topic; Practice Patterns, Physicians' - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sleep; Specialization; Stress Disorders, Post-Traumatic - therapy; translational research; veterans; Veterans - psychology; Human; Chemotherapy; Posttraumatic syndrome; Treatment; Psychotropic; Professional practice; Anxiety disorder; Psychotherapy; Antidepressant agent; Veteran; Recommendation; Stress
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1023/B:JOTS.0000029264.23878.53

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.