Advances in PTSD Treatment Delivery: Evidence Base and Future Directions for Intensive Outpatient Programs
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PTSD (S Creech and L Sippel, Section Editors)
Advances in PTSD Treatment Delivery: Evidence Base and Future Directions for Intensive Outpatient Programs Katie A. Ragsdale, Ph.D. Laura E. Watkins, Ph.D. Andrew M. Sherrill, Ph.D. Liza Zwiebach, Ph.D.* Barbara O. Rothbaum, Ph.D., ABPP Address * Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, Atlanta, GA, 30329, USA Email: [email protected]
* Springer Nature Switzerland AG 2020
This article is part of the Topical Collection on PTSD Keywords PTSD I Intensive outpatient I Evidence-based treatment I Massed treatment
Abstract Purpose of review Traditionally, evidence-based treatment for PTSD is delivered in an outpatient format with dropout rates ranging from 30 to 62%. Modifications of existing protocols for delivery in intensive outpatient format offer promise for retention and excellent therapeutic outcomes. This article will review the existing literature on evidence-based psychotherapy for PTSD delivered within an intensive outpatient format. Recent findings Studies indicate that the intensive outpatient format substantially increases retention rates and demonstrates treatment outcomes at least equivalent to those demonstrated in traditional outpatient settings. Findings are limited by the dearth of randomized clinical trials to date. Summary Current research highlights the utility of implementing evidence-based PTSD treatment in massed intensive format, which evidences improved treatment retention and comparable outcomes with traditional outpatient formats.
PTSD (S Creech and L Sippel, Section Editors)
Introduction Evidence-based psychotherapy for PTSD exists in many forms [1]. The evidence bases for exposure-based therapy (e.g., prolonged exposure; [2]) and cognitive processing therapy (CPT) [3], in particular, are robust and extensive [4]. However, when delivered in their traditional weekly session format, each of these treatments is subject to a high dropout rate [5•]. Reasons for the high rate of attrition are varied but include avoidance symptoms endemic to the PTSD population. Efforts to reduce barriers and increase completion of trauma-focused treatments (TFTs) have taken center stage in both research and clinical practice. One such effort is the adaptation of standardized weekly outpatient traumafocused treatments to intensive outpatient programs (IOPs). Such IOPs provide a therapeutic dose of evidence-based PTSD treatment within a condensed
and intensive (e.g., 2- or 3-week) treatment time frame. While specific programming differs across settings, IOPs often combine additional or adjunctive services with the first-line PTSD treatment; additional services might include group therapy or interventions related to overall wellness [6•]. Targeting PTSD within an IOP framework is an attempt to increase access to evidence-based treatment for PTSD, reduce barriers to care such as avoidance, reduce dropout rates among treatment seekers, and improve outcomes in PTSD treatment. Preliminary evi
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