PTSD: National Center for PTSD
Executive Division Research
Executive Division Research
The Executive Division in White River Junction, VT, supports the National Center's mission by providing leadership, directing program planning, and promoting collaboration in order to facilitate optimal functioning of each division individually and collectively. The Division specializes in the development of innovative and authoritative educational resources, programs that disseminate and implement best management clinical practices, and the use of technologies to reach a broad range of audiences.
The Division has a long history of participation in VA's Cooperative Studies Program (CSP). Enrollment began for CSP #591, a groundbreaking study that compares Prolonged Exposure to Cognitive Processing Therapy. The study, which will enroll 900 Veterans at 17 sites across the country, will help VA leadership, clinicians, and Veterans make informed choices about PTSD care in VA, and will also be broadly relevant to the scientific and clinical communities outside VA.
Investigators continue to focus on issues that frequently co-occur with PTSD. A 5-site randomized clinical trial of Acceptance and Commitment Therapy for distress and impairment in OEF/OIF/OND Veterans was completed and analyses are in the final stages, while two other trials focusing on co-occurring substance use disorders and PTSD are continuing. One compares cognitive behavioral therapy for PTSD plus usual outpatient addiction care versus usual care alone, and the other compares Prolonged Exposure with Seeking Safety. In addition, data are currently being analyzed to evaluate whether a brief educational handout on mild traumatic brain injury (mTBI) improves Veterans' knowledge and understanding of TBI and the meaning of screening results. Secondary analyses will identify clinic-level barriers and facilitators to implementing the handout into practice.
Analyses are ongoing of data from the evaluation of several of the Center's online products. Investigators surveyed civilian and military personnel samples from an online research panel to evaluate the Understanding PTSD Treatment course and its companion PDF, as well as PTSD Coach Online. Investigators are also analyzing data from an online survey completed by psychiatrists and general practitioners to assess the impact of one of the Center's PTSD 101 courses, An Overview of the VA/DoD Clinical Practice Guideline for PTSD. These evaluation studies offer insights into user and use characteristics, as well as how various products may improve attitudes, behaviors, knowledge, or mental health.
Dissemination and Implementation Research
The Division continues work on several initiatives aimed at assessing models of care and improving evidence-based practice. A survey study to assess patients' decisional needs and preferences for PTSD treatment is in the planning stages; the results will inform the development of an online patient decision aid. An ongoing initiative examines the impact of an academic detailing model to reduce inappropriate prescribing practices for PTSD patients and uses decision support tools to encourage the use of shared decision making. A related project will determine if the use of a clinical pharmacist in an academic detailing model can improve local PTSD prescribing practices in rural clinics throughout Vermont and Maine.
In addition to projects aimed at improving clinical practices, investigators are continuing to assess the state of VA care for PTSD. Results of a completed study of models of care within PTSD Clinical Teams will enhance the mission of the PTSD Mentoring Program that is managed by the Executive Division. Work just began on a project that applies novel informatics and operational methods to medical and administrative data in order to understand multiple dimensions of quality of PTSD care within VA.