Expanding the Reach of Effective PTSD Treatment Into Primary Care: Prolonged Exposure for Primary Care.

Abstract

Posttraumatic stress disorder (PTSD) is a costly mental health issue in the United States and throughout the world. Effective treatments are available; however, most people with PTSD never access these treatments. Prolonged exposure (PE) therapy has emerged as an effective, first-line treatment for PTSD and is provided in specialty mental health in eight to 15 sessions, each lasting 90 minutes. Most people with PTSD do not enter specialty mental health to access this service. Over the past 15 years, provision of mental health care in primary care has increased due to patient preference for care in this setting and the ability to overcome many access barriers (stigma, longer sessions, insurance coverage, etc.). While medications for PTSD are available in primary care, effective brief psychotherapeutic PTSD treatment options have only recently been established. PE-PC (prolonged exposure for primary care) is a brief version of PE therapy for PTSD with efficacy in a primary care (PC) setting in reducing PTSD, depression, and related mental disorder symptoms. PE-PC has four 30-minute sessions and focuses on imaginal exposure to the trauma memory, in vivo exposure to trauma-related avoidance, and emotional processing of the memory. Dissemination efforts are currently underway to expand availability.