(PS4-93) PTSD Treatment Outcomes of Three Evidence Based Practices for Military-Affiliated Clients in a Community Mental Health Network

Posttraumatic stress disorder (PTSD) is a critical concern among veterans, active-duty service members and military family members, yet existing research on PTSD treatment in military populations is almost entirely derived from Department of Defense (DoD) or VA studies. As a result, little is known about treatment outcomes for military affiliated (veterans, active duty service members, and their family members) personnel receiving care in community-based settings. This study examines real-world PTSD treatment outcomes for military affiliated clients within Cohen Veterans Network (CVN), a national nonprofit organization providing evidence-based mental health care to military-affiliated populations outside Defense Health Agency (DHA) or Veterans Health Administration (VHA) systems.

Data from 2,734 military affiliated client diagnosed with and treated for PTSD across Cohen Veterans Network with at least two PCL-5 scores recorded (pre/post) in their electronic health record were analyzed. Cohen Clinics employ Measurement-Based Care, routinely collecting standardized patient reported outcome measures and recording which treatment was provided at each session. Symptom change was measured using the PTSD Checklist for DSM-5 (PCL-5), and treatment completion rates. Demographic differences were also assessed. Outcomes examined treatment results for clients who received at least 4 or 8 sessions of the included treatments. Treatments included Prolonged Exposure (PE, n of 145 and 80 for 4 or more and 8 or more sessions), Cognitive Processing Therapy (CPT, n of 627 and 373), or Eye Movement Desensitization and Reprocessing (EMDR, n of 337 and 153). Results indicated that clients with at least 4 completed sessions had an average PCL-5 change of 17.41 with PE, 19.43 with CPT, and 16.82 with EMDR. After 8 or more sessions, the average change was 19.34 for PE, 24.40 for CPT, and 18.24 for EMDR. Female clients showed greater symptom reduction than their male counterparts. Differences were also seen for client type with the most change for family members, followed by veterans, then active duty service members. Retention rates also varied by treatment provided.

These findings highlight the value of evidence-based PTSD care protocols provided to military affiliated clients in military-competent community settings as each of the three treatments proved highly and similarly effective, achieving clinically meaningful improvement on average. This suggests a role for community-based military and veteran service organizations including Cohen Veterans Network in enhancing access to care for military affiliated clients. Further research is needed to refine treatment engagement strategies which optimize service delivery options and behavioral health outcomes for these client populations.