Symposia
Trauma and Stressor Related Disorders and Disasters
Alyssa C. Jones, Ph.D.
Ralph H. Johnson VA Medical Center and Medical University of South Carolina
Charleston, South Carolina
Ursula Myers, Ph.D.
Clinical Psychologist and Research Assistant Professor
Ralph H. Johnson VA Medical Center and Medical University of South Carolina
Charleston, South Carolina
Bethany Wangelin, Ph.D.
Clinical Psychologist and Research Assistant Professor
Ralph H. Johnson VA Medical Center and Medical University of South Carolina
Charleston, South Carolina
Advances in posttraumatic stress disorder (PTSD) treatment research have provided patients with more intervention choices (Cusack et al., 2016), and advancements in technology have facilitated more treatment modality options (e.g., in-person, telehealth; Morland et al., 2019). Unfortunately, it is common for individuals with PTSD to not be provided the choice of preferred intervention or treatment format (Le et al., 2018). Treatment preference may positively impact treatment outcomes (e.g., Le et al., 2018), although more work is needed to better understand the role of treatment preference in treatment outcomes. This is especially important in contexts where treatment options are more limited, such as throughout the COVID-19 pandemic. The present study examined how patients engaged with PTSD specialty care when treatment options were limited during the COVID-19 outbreak. Pre-COVID, our clinic was a hybrid in-person/telehealth model (40% in-person, 60% telehealth), with individuals selecting the modality. As a result of COVID-19, all patients were transitioned into home-based telehealth appointments. This study examined whether patients who had selected in person before dropped out, or whether they stayed in treatment in a new modality.
Participants included 87 Veterans scheduled for in-person appointments within a PTSD specialty clinic (both initial assessments and current patients) when the mandated switch to telehealth occurred due to the COVID-19 outbreak in March 2020. Participants were tracked through chart reviews from March 2020 through July 2020.
Of the 87 Veterans scheduled for appointments in March 2020, 75% (n = 65) of Veterans made the switch to a telehealth appointment and continued in treatment. 11% (n = 10) dropped out of treatment altogether for reasons including not showing for scheduled intake (n = 5) or deciding that care was not currently needed (n = 3). 9% (n = 8) of Veterans only wanted and/or engaged in phone appointments (i.e., not video), and 5% (n = 4) paused treatment and then resumed in-person when it was permitted in July 2020.
Results from this study suggest that the majority of Veterans were able to continue engaging in treatment, including evidence-based treatments (as opposed to more supportive therapy), despite not choosing the format (i.e., in person vs. video). These data suggest that even when patient preferences are not able to be accommodated, patients may still be able to engage in treatment.