Publication year
2013
Citation Title
Outcomes of participation in the REACH multifamily group program for veterans with PTSD and their families.
Journal Name
Professional Psychology: Research and Practice
Journal Volume
44
Issue Number
3
Page Numbers
127-134
DOI
10.1037/a0032024
Summary
Multifamily group approaches (such as REACH: Reaching out to Education and Assist Caring, Healthy Families) to care for Veterans with posttraumatic stress disorder (PTSD) are both critical and effective, as they involve family members who are also affected by and affect treatment outcomes. Veterans and family members who participated in REACH have shown improvements over time via self-reported measurements on areas including relationship satisfaction, social support, depression, and anxiety.
Key Findings
Overall, Veterans demonstrated improvements over time on all outcomes, except for relationship satisfaction when it was not distressed at baseline.
On average, following the end of REACH, Veterans used fewer outpatient mental health services.
Family members' scores on social support, depression, and anxiety showed improvement over time, as well as relationship satisfaction for those who had distressed relationship scores at baseline.
Implications for Program Leaders
Incorporate a multifamily group format to educational and treatment programs that serve Service members living with PTSD
Support group cohesion and human connections as a part of the therapeutic process
Provide multifamily group programs for nonveterans, Veterans who receive treatment outside the Veteran Affairs (VA) hospital setting, and Reservists
Implications for Policy Makers
Promote treatment and education programs that involve family members
Encourage family preparations during Service member deployment to ready families for any possible therapeutic processes
Develop alternative group therapy options for Service members who may be geographically separated from family members
Methods
Participants were Veterans receiving services at the Oklahoma City Veteran Affairs Medical Center (VAMC).
Veterans were eligible to participate in the study if they had a primary diagnosis of PTSD and had an adult family member or friend willing to participate.
Individuals who had an active substance abuse problem or who were suicidal or homicidal were excluded.
Participants
One hundred Veterans and 96 family members who pariticpated in REACH completed the evaluation.
Veterans were predominately male (99%), between 22 and 85 years old (M = 55.8, SE = 1.25), and White (87%). Most participants (87%) reported as being married or cohabiting.
Family members were mostly women (91%), between 20-85 years old (M = 52.7, SE 1.38), and White (82%).
Limitations
Without having a comparison group, it is unclear whether any improvements that were observed were directly related to the Veterans' participation in REACH.
There was not a subscale directly related to PTSD; therefore, PTSD symptom severity could not be assessed.
The study had participants from a single site who have been dealing with PTSD for a long time (primarily Vietnam, Persian Gulf, and earlier service- era Veterans), therefore, the outcomes observed cannot be generalized to Veterans from more recent wars.
Avenues for Future Research
Include a collection of data from a broad sample who have not been able to access the services of REACH (or similar services) to use as a comparison group
Use Service members who represent a broader geographic representation, more recent-onset PTSD or Service members who may be participating in programs similar to REACH but are not family inclusive
Test similar program outcomes with regard to common comorbidities with PTSD, such as substance use disorder and mild traumatic brain injury
Focus
Multiple Branches
Population Focus
Military Branch
Military Component
Abstract
Posttraumatic stress disorder (PTSD) is prevalent among users of the Veterans Affairs (VA) health care system. Effective approaches to involving family in care for PTSD are critical because family functioning both affects and is affected by treatment outcomes. Although multifamily group treatment is an evidence-based practice for schizophrenia and other serious mental illnesses, no data have been published on its effectiveness for those living with PTSD and their family members. This study examined the impact of participation in REACH (Reaching out to Educate and Assist Caring, Healthy Families), an adaptation of the multifamily group psychoeducation program tailored for delivery to veterans with PTSD and their family members. One hundred veterans with PTSD and 96 family members who participated in the 9-month, 3-phase clinical program between 2006 and 2010 also participated in this longitudinal evaluation. Veterans showed significant (p < .05) improvements over time on all measures (empowerment, family problem solving and communication, relationship satisfaction, social support, symptom status, knowledge of PTSD, self-efficacy in coping with PTSD, and quality of life). Family members showed similar statistically significant improvements on most measures. Changes over time in individual participants' relationship satisfaction, social support, symptom status, and quality of life were attributable to changes in program-targeted knowledge and skills. Study results suggest that multifamily group psychoeducation is useful in treatment of PTSD, leading to increases in targeted PTSD knowledge and skills, as well as improving family functioning and symptom status for both veterans and family members. Implications for clinicians and recommendations for further evaluation of this promising intervention are described.
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