Prolonged Exposure in Primary Care
The United States Air Force (AF) partnered with researchers at the Clearinghouse for Military Family Readiness at the Penn State (Clearinghouse) to conduct a beta test of Prolonged Exposure in Primary Care (PE-PC). PE-PC is a standardized and manualized intervention that is designed for primary care settings and utilizes components from Prolonged Exposure (PE). Treatment involves the use of a workbook to process the traumatic event in the form of a narrative. Providers assist in processing emotions and problematic beliefs associated with patient trauma, provide support for in vivo exposure homework, and offer education and strategies for relapse prevention. Appointments are scheduled at 1- to 2-week intervals. In comparison to other, longer PTSD interventions, PE-PC consists of an intake session and only four individual 30-minute sessions. The beta test focused on examining the feasibility and utility of utilizing PE-PC treatment with patients in the AF’s Behavioral Optimization Program (BHOP); a service that integrates behavioral health care into the AF’s primary care clinic. In terms of feasibility and utility, all results indicate that PE-PC is an intervention well-suited for use within BHOP. This is evidenced in (1) the fit of PE-PC within the BHOP model; (2) provider satisfaction and feedback; and (3) beta test patient outcomes, although these are limited in quantity. The Clearinghouse recommended an AF-wide phased implementation of PE-PC because of the relative low cost of training providers in PE-PC and the need to be able to treat PSTD within the primary care setting. This phased unveiling should be linked with a rigorous outcome evaluation.