Study on skills building/psychoed before PTSD EBP

[cara susanna]

I recently found out about this study, which looked at offering psychoed or skills building before a PTSD EBP. The study found that, not only did skills building or psychoed prior to treatment NOT improve dropout rates, patients who did preparatory work were 1) less likely to follow up with an EBP and 2) less likely to benefit from an EBP.

APA PsycNet

doi.apa.org

Imo, yet another nail in the coffin for the step-based PTSD approach/"complex" PTSD guidelines.

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[WisNeuro]

The real question is, how many of those who didn't follow up, get their SC determination in the interim?

 

[summerbabe]

N= 1 but I have found it pretty helpful to teach some very specifically targeted and brief DBT distress tolerance as a brief precursor to being more able to engage with intensive treatments. But agree that psychoed and 1 size fits all coping isn't nearly as helpful as pre-treatment work can be.

 

[DynamicDidactic]

N= 1 but I have found it pretty helpful to teach some very specifically targeted and brief DBT distress tolerance as a brief precursor to being more able to engage with intensive treatments. But agree that psychoed and 1 size fits all coping isn't nearly as helpful as pre-treatment work can be.

Do you do DBT-PE? Or is this in reference to a broad approach?

 

[summerbabe]

Do you do DBT-PE? Or is this in reference to a broad approach?

No, I was speaking more generally but know people who do DBT-PE and it seems like it can be really effective when somebody has significant trauma that DBT alone won't address and significant emotion regulation difficulties that could get in the way of engaging in trauma treatment via maladaptive avoidance/coping.

 

[cara susanna]

No, I was speaking more generally but know people who do DBT-PE and it seems like it can be really effective when somebody has significant trauma that DBT alone won't address and significant emotion regulation difficulties that could get in the way of engaging in trauma treatment via maladaptive avoidance/coping.

The thing is, although a lot of clinicians do skills building prior to trauma-focused therapy, the research that we have so far suggests it may not be necessary. I find the disconnect between what the field practices and what the research actually supports very fascinating.

Not really talking about DBT-PE, though. They have a pretty solid framework and rationale for that approach, and imo have thought out the process well. Plus, I think it makes sense not to approach BPD like you would "pure" PTSD. I don't do it DBT-PE but I am trained in it. In fact, a paper that criticizes the ISTSS c-PTSD treatment guidelines cites Harned's work.

 

[Sanman]

The thing is, although a lot of clinicians do skills building prior to trauma-focused therapy, the research that we have so far suggests it may not be necessary. I find the disconnect between what the field practices and what the research actually supports very fascinating.

Not really talking about DBT-PE, though. They have a pretty solid framework and rationale for that approach, and imo have thought out the process well. Plus, I think it makes sense not to approach BPD like you would "pure" PTSD. I don't do it DBT-PE but I am trained in it. In fact, a paper that criticizes the ITSTSS c-PTSD treatment guidelines cites Harned's work.

While I am not doing PE or CPT with my folks, I always like to include skills work as precursor to deeper work as well. I find it helps with rapport building as well as giving those that are more concrete something to practice. That said, I feel that the way skills groups often are setup at places like the VA, it is gives patients a place to go while on the (usually long) waitlist for something like individual PE or CPT.

 

[summerbabe]

That said, I feel that the way skills groups often are setup at places like the VA, it is gives patients a place to go while on the (usually long) waitlist for something like individual PE or CPT.

I think this is really key because there’s a world of difference sitting in a PTSD 101 class versus doing some really targeted skills building that’s 100% specific to that person with follow-up for fine-tuning.