Are decisions to depart from a prescribed treatment format and content foolhardy or signs of ingenuity? Working at a clinical training site, I will often get asked about possible modifications to treatment protocols or when it might be acceptable to deviate from a protocol. This issue raises several important questions about clinical practice and the underlying factors that influence our choices when providing patient care. To explore the issue of departing or making modifications to treatment protocols, I surveyed a panel of our CDP staff that has extensive experience in providing training and consultation on evidence based treatment protocols to get their feedback on the following questions.
Blog posts with the tag "Staff Perspective"
Over the past year I’ve taught multiple workshops on “CBT for Depression in the Military” to both uniformed and civilian providers, and one of the things I’ve noticed is that participants are often unfamiliar with the general structure of cognitive behavioral therapy (CBT) sessions.
As clinicians who veterans and active service members, many of us see residual symptoms following successful treatment. We have patients who have successfully completed exposure treatment who were very capable of rehearsing their traumas and reducing their anxiety, yet some of them continue to show stubborn residual agitation. Their stories have become more coherent as they work through successive exposures, they progress through in vivo experiences, and their functioning improves. Their description sounds like their baseline anxiety level has gone from 3 to 5.
In today's Staff Perspective on the CDP's blog, Dr. Regina Shillinglaw discusses the use of the modifier "Interrupted" in suicide nomenclature. She examines the correct usage and even provides a few examples.
Participants at our evidence-based psychotherapy (EBP) workshops often ask how to determine when patients are ready to engage in these treatments. When I read the article, "VA PTSD Clinic Director Perspectives: How Perceptions of Readiness Influence Delivery of Evidence-Based PTSD Treatment," I was struck by how universal these concerns are. The article describes how providers in VA clinics across the country are addressing these concerns. In reviewing their findings, we might reconsider the assumptions that we each make about patient readiness for EBPs.