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Behavior Modification
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*Post-Traumatic Stress Disorder
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What's this?

Disseminating Evidence-Based Practices for Adults With PTSD and Severe Mental Illness in Public-Sector Mental Health Agencies

B. Christopher Frueh

The Menninger Clinic and Baylor College of Medicine

Anouk L. Grubaugh

Veterans Affairs Medical Center and Medical University of South Carolina, Charleston

Karen J. Cusack

University of North Carolina, Chapel Hill

Jon D. Elhai

The University of South Dakota, Vermillion

Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mental illnesses (SMI). The treatment of psychotic symptoms usually takes precedence in the care of adults with SMI. Such oversight is problematic in that PTSD in SMI populations is common (19%-43%), contributes a significant illness burden, and hinders mental health care. Yet few public-sector mental health agencies routinely provide specialized services for PTSD. The purpose of the article is to describe strategies and efforts to disseminate trauma-focused empirically based practices in a public-sector mental health system. Identified challenges include limited resources and commitment; knowledge deficits, attitudes, and biases; and limited practice accountability at provider, facility, and system levels. Proposed strategies for overcoming these challenges are to set clear goals, nurture broad-based organizational commitment and key stakeholder involvement, implement specialty training efforts to provide information and change attitudes, provide ongoing supervision, conduct fidelity monitoring, and ensure accountability to the extent possible.

Key Words: PTSD • severe mental illness • cognitive-behavioral therapy • dissemination • empirically based practices

This version was published on January 1, 2009

Behavior Modification, Vol. 33, No. 1, 66-81 (2009)
DOI: 10.1177/0145445508322619
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