A pilot study of interpersonal process group therapy for PTSD in Canadian veterans
Abstract: Introduction: The present pilot study was designed to explore interpersonal process (IP) group therapy for post-traumatic stress disorder (PTSD); a novel and relatively untested treatment approach for PTSD. IP groups seek to normalize patients’ symptoms and enhance functioning by creating a safe environment wherein participants can engage with others who share similar experiences and symptoms. Methods: Present IP groups met weekly for 12 weeks. Participants included 20 Canadian male Veterans and RCMP officers (10 per treatment group) with a primary diagnosis of PTSD. All participants had previously received first-line treatments for PTSD but continued to experience serious limitations in functioning. Key measures of interest (i.e., PTSD, negative affect, moral injury) were administered immediately pre- and post-intervention. Qualitative data was collected from a subset of participants (n = 6). Results: Baseline scores revealed significantly elevated symptom levels compared to normative and clinical samples. Retention rate over the course of therapy was 100%, a rare and important finding in clinical research generally, and in the PTSD population more specifically. Qualitative feedback was consistently positive; feedback also suggested future potential improvements for the therapeutic intervention. There was a significant reduction in anxiety (specifically, physiological hyperarousal) pre- to post-intervention, with a partial eta squared (n2 p) value of 0.26, indicating a large effect size. Discussion: Examination of individual scores showed that fully one-third of participants demonstrated a reliable improvement in both physiological anxiety and anxiety sensitivity (AS), both of which have been implicated in the exacerbation and maintenance of other PTSD symptoms. Results support a randomized controlled trial of group IP for PTSD.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.