Predictors of Treatment Access and Initiation Among Diverse, Low-Income Victims of Violence Offered a Trauma-Focused Evidence-Based Psychotherapy.

Many victims of violence may benefit from trauma-focused evidence-based psychotherapies (EBPs), but fail to utilize treatment. The current study investigated factors associated with treatment access and treatment initiation in a low-income, racially and ethnically diverse, urban population of victims of violence who were screened for EBPs. The sample consisted of 941 adults, mean age = 35.87 (SD = 12.8), who were screened for mental health treatment and offered an EBP. Overall, 55.7% of individuals accessed treatment by attending an in-person screening appointment and intake, and 79.0% of the individuals who accessed treatment then initiated treatment by attending the first EBP session. Analysis revealed higher age (odds ratio [OR] = 1.05, 95% confidence interval (CI) = [1.04, 1.09]) and lower expression of posttraumatic stress disorder (PTSD) symptoms predicted higher rates of accessing treatment (OR = 0.20, 95% CI = [0.05, 0.82]). Higher global severity of distress (OR = 3.22, 95% CI = [1.14, 9.10]), poor quality of life in the area of psychological health (OR = 0.90, 95% CI = [0.81, 1.00]), and better quality of life in the area of physical health significantly predicted initiation of treatment (OR = 1.11, 95% CI = [0.998, 1.24]). Findings suggest that low-income, ethnically and racially diverse victims of violence may effectively utilize trauma-focused EBPs offered in a community setting.

Feasibility of Training Frontline Therapists in Prolonged Exposure: A Randomized Controlled Pilot Study of Treatment of Complex Trauma in Diverse Victims of Crime and Violence.

The study aims were to determine whether prolonged exposure (PE) improved mental health and was feasible to implement by frontline clinicians in a culturally diverse sample with complex trauma. Seventy-one individuals were randomly assigned to PE or person-centered therapy (PCT). Outcome measures were administered at baseline and sessions 3, 6, 9, and 12. Mixed modeling was used to regress outcome measures on time, treatment group, and number of visits. Individuals who received PE showed significant moderate association with decline in reported posttraumatic stress disorder (PTSD) symptoms as noted by the PTSD Checklist for DSM-5 (p = 0.05) compared with PCT. Results indicated improved scores on all measures at each follow-up time point compared with baseline (p ≤ 0.01). PE was feasible, shown by positive recruitment and ability of clinicians to effectively implement and maintain treatment fidelity. Findings suggest that PE can be effective for treating complex trauma when used by clinicians in community settings.