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- Title
Home-based delivery of variable length prolonged exposure therapy: A comparison of clinical efficacy between service modalities.
- Authors
Morland, Leslie A.; Mackintosh, Margaret‐Anne; Glassman, Lisa H.; Wells, Stephanie Y.; Thorp, Steven R.; Rauch, Sheila A. M.; Cunningham, Phillippe B.; Tuerk, Peter W.; Grubbs, Kathleen M.; Golshan, Shahrokh; Sohn, Min Ji; Acierno, Ron; Mackintosh, Margaret-Anne
- Abstract
<bold>Objective: </bold>This study examined clinical and retention outcomes following variable length prolonged exposure (PE) for posttraumatic stress disorder (PTSD) delivered by one of three treatment modalities (i.e., home-based telehealth [HBT], office-based telehealth [OBT], or in-home-in-person [IHIP]).<bold>Method: </bold>A randomized clinical trial design was used to compare variable-length PE delivered through HBT, OBT, or IHIP. Treatment duration (i.e., number of sessions) was determined by either achievement of a criterion score on the PTSD Checklist for Diagnostic and Statistical Manual-5 (DSM-5; PTSD Checklist for DSM-5) for two consecutive sessions or completion of 15 sessions. Participants received PE via HBT (n = 58), OBT (n = 59) or IHIP (n = 58). Data were collected between 2012 and 2018, and PTSD was diagnosed using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), administered at baseline, posttreatment, and 6 months following treatment completion. The primary clinical outcome was CAPS-5 PTSD severity. Secondary outcomes included self-reported PTSD and depression symptoms, as well as treatment dropout.<bold>Results: </bold>The clinical effectiveness of PE did not differ by treatment modality across any time point; however, there was a significant difference in treatment dropout. Veterans in the HBT (odds ratio [OR] = 2.67; 95% confidence interval [CI] = 1.10, 6.52; p = .031) and OBT (OR = 5.08; 95% CI = 2.10; 12.26; p < .001) conditions were significantly more likely than veterans in IHIP to drop out of treatment.<bold>Conclusions: </bold>Providers can effectively deliver PE through telehealth and in-home, in-person modalities although the rate of treatment completion was higher in IHIP care.
- Subjects
EXPOSURE therapy; EXPERIMENTAL design; PRE-exposure prophylaxis; POST-traumatic stress disorder; CLINICAL trials
- Publication
Depression & Anxiety (1091-4269), 2020, Vol 37, Issue 4, p346
- ISSN
1091-4269
- Publication type
journal article
- DOI
10.1002/da.22979