TY - JOUR
T1 - Treatment of comorbid pain and PTSD in returning veterans
T2 - A collaborative approach utilizing behavioral activation
AU - Plagge, Jane M.
AU - Lu, Mary W.
AU - Lovejoy, Travis I.
AU - Karl, Andrea I.
AU - Dobscha, Steven K.
N1 - Funding Information:
Conflict of interest and acknowledgment of support: No author reports having any financial or other potential conflict of interest with this study. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. This work was supported by the Pacific Northwest Mental Illness Research and Education and Clinical Center (MIRECC) and VA Mental Health Services. The authors acknowledge Alex Linke, BS, for assistance with utilization data extraction, and Amy Wagner, PhD, for assistance in implementing behavioral activation and for reviewing the manuscript.
PY - 2013/8
Y1 - 2013/8
N2 - Objective: We explore preliminary clinical effectiveness and feasibility of an intervention utilizing collaborative care components and behavioral activation (BA) to treat comorbid chronic pain and posttraumatic stress disorder (PTSD). Design: Descriptive, including pre- and posttreatment assessment results. Setting: Portland Veterans Affairs Medical Center. Participants: Fifty-eight Iraq and Afghanistan veterans with chronic pain and PTSD symptoms. Interventions: Veterans participated in a biopsychosocial evaluation and up to eight BA sessions using a collaborative approach involving primary care, mental health, and other clinicians. A physiatrist assisted the psychologist in providing recommendations to primary care providers. Outcome Measures: Participants were administered pre- and posttreatment measures of PTSD, pain severity, pain interference, mental health, quality of life, satisfaction, and global ratings of change with the purpose of assessing progress and improving quality. Results: Of the 58 participants, 30 completed treatment. Common recommendations included physical therapy and exercise programs, pain medication or pain medication adjustments, and additional diagnostic workups, such as imaging. Participants who completed the program showed significant improvements on measures of PTSD, pain severity, and pain interference. Improvements were also evident on measures of mental health and quality of life. Overall, participants were satisfied with the program, and on average reported feeling "somewhat better." Conclusions: These findings suggest that a collaborative approach that includes BA is feasible and a potentially effective treatment for comorbid chronic pain and PTSD.
AB - Objective: We explore preliminary clinical effectiveness and feasibility of an intervention utilizing collaborative care components and behavioral activation (BA) to treat comorbid chronic pain and posttraumatic stress disorder (PTSD). Design: Descriptive, including pre- and posttreatment assessment results. Setting: Portland Veterans Affairs Medical Center. Participants: Fifty-eight Iraq and Afghanistan veterans with chronic pain and PTSD symptoms. Interventions: Veterans participated in a biopsychosocial evaluation and up to eight BA sessions using a collaborative approach involving primary care, mental health, and other clinicians. A physiatrist assisted the psychologist in providing recommendations to primary care providers. Outcome Measures: Participants were administered pre- and posttreatment measures of PTSD, pain severity, pain interference, mental health, quality of life, satisfaction, and global ratings of change with the purpose of assessing progress and improving quality. Results: Of the 58 participants, 30 completed treatment. Common recommendations included physical therapy and exercise programs, pain medication or pain medication adjustments, and additional diagnostic workups, such as imaging. Participants who completed the program showed significant improvements on measures of PTSD, pain severity, and pain interference. Improvements were also evident on measures of mental health and quality of life. Overall, participants were satisfied with the program, and on average reported feeling "somewhat better." Conclusions: These findings suggest that a collaborative approach that includes BA is feasible and a potentially effective treatment for comorbid chronic pain and PTSD.
KW - Behavioral Activation
KW - Collaborative Care
KW - Pain
KW - Posttraumatic Stress Disorder
KW - Veterans
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U2 - 10.1111/pme.12155
DO - 10.1111/pme.12155
M3 - Article
C2 - 23746043
AN - SCOPUS:84882687825
SN - 1526-2375
VL - 14
SP - 1164
EP - 1172
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 8
ER -