Improving Voluntary Engagement for Posttraumatic Stress Disorder Treatment Among Active-Duty Service Members Using Motivational Enhancement Therapy

Abstract

Objective: Posttraumatic stress disorder (PTSD) prevalence in the military is high and effective treatments are underutilized. Motivational enhancement therapy (MET) “check-ups” are brief interventions to elicit treatment uptake for those who are nontreatment seeking. The aim of the current study was to test the efficacy of a novel MET intervention designed to promote treatment engagement among activeduty U.S. military personnel with untreated PTSD. Method: One hundred and sixty-one active-duty service members who met the criteria for PTSD were randomized to MET or treatment as usual (TAU, treatment resource and referral). MET participants (n = 82) received up to three 30–90 min telephone sessions. TAU participants (n = 79) were mailed PTSD resources and referrals. Follow-up assessments were conducted 6-week, 3- and 6-month postbaseline. Results: Mixed effect model results indicated treatment uptake significantly increased over time but there were no significant differences between conditions or interactions. PTSD symptom severity significantly decreased for both conditions. There was also a significant three-way interaction with baseline readiness-to-change confidence. Those low in baseline readiness-to-change saw more favorable effects of MET (relative to TAU) at 6-month follow-up. Conclusions: Results suggest both MET and high-quality referral options have promise as a means of increasing evidence-based treatment uptake and decreasing PTSD for service members with PTSD. MET may be particularly useful for individuals with low confidence in their ability to address PTSD. Given the individual and societal costs of PTSD, there is a need for interventions facilitating treatment uptake.