Dropout from trauma-focused treatment for posttraumatic stress disorder (PTSD) represents a daunting challenge for the field, particularly among military and veteran samples. Family involvement may help to increase the effectiveness of PTSD treatment while also improving retention. We tested a two-session brief family intervention (BFI) protocol delivered as an adjunct to individual trauma-focused treatment among a sample of 20 veteran–family member dyads (N = 40). Willingness to participate in the family-inclusive protocol was high, with over 85% of veterans and family members who were screened agreeing to take part. All enrolled veterans were beginning a course of either cognitive processing therapy (CPT) or prolonged exposure (PE), delivered in outpatient Veterans Affairs clinics. Family members were randomized to either receive or not receive the BFI from study clinicians. In the BFI condition, 20.0% of veterans dropped out of CPT/PE before the 16-week study end; the remainder were either still attending on-protocol sessions or had completed the full protocol. In the control condition, 40.0% of veterans dropped out of CPT/PE before the end of the study. Observed significant, large-magnitude decreases in PTSD symptoms over time did not differ by condition, ESsg range = −1.12 to −2.04. Accommodation did not significantly decrease over time in either condition, ESsg range = 0.18 to −0.98. The BFI represents a promising option for veterans, family members, and clinicians who are seeking a brief, feasible, narrowly focused method for incorporating families into veterans’ individual trauma-focused therapy and potentially reducing the rate of dropout.

中文翻译：

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在个体创伤治疗中使用简短的家庭干预来减少退伍军人的辍学：一项随机对照试验


退出以创伤为中心的创伤后应激障碍（PTSD）治疗对该领域来说是一项艰巨的挑战，特别是在军人和退伍军人样本中。家庭参与可能有助于提高创伤后应激障碍（PTSD）治疗的有效性，同时也可以提高保留率。我们在 20 名退伍军人家庭成员二人组（ N = 40）中测试了作为个人创伤重点治疗的辅助手段的两次简短家庭干预 (BFI) 方案。参与家庭包容协议的意愿很高，接受筛查的退伍军人和家庭成员中有超过 85% 同意参加。所有登记的退伍军人都开始在退伍军人事务诊所门诊进行认知处理治疗（CPT）或长期暴露（PE）疗程。家庭成员被随机分为接受或不接受研究临床医生提供的 BFI。在 BFI 条件下，20.0% 的退伍军人在 16 周研究结束前退出 CPT/PE；其余的人要么仍在参加按方案举行的会议，要么已完成完整的方案。在对照条件下，40.0%的退伍军人在研究结束前退出了CPT/PE。随着时间的推移，观察到的 PTSD 症状显着大幅减少，并没有因病情而异，ESsg 范围 = -1.12 至 -2.04。在任何一种情况下，适应性都没有随着时间的推移而显着减少，ESsg 范围 = 0.18 至 -0.98。对于退伍军人、家庭成员和临床医生来说，BFI 是一个有前途的选择，他们正在寻求一种简短、可行、针对性强的方法，将家庭纳入退伍军人的个人创伤治疗，并有可能降低退出率。