School for Social Work
Psychotherapists-Decision-making, Post-traumatic stress disorder-Treatment, Combat-Psychological aspects, Sexual abuse victims-Counseling of, United States-Armed Forces-Women-Crimes against, Women soldiers-Crimes against, Combat trauma, Military sexual trauma, Decision-making, Patient influence
Combat-related trauma and military sexual trauma (MST) are two types of trauma one can be exposed to while serving in the military. Although there are some similarities in the two types of trauma there are many more differences. Therefore, this study investigated what factors influence clinicians' treatment decisions for combat-related trauma and military sexual trauma and whether or not clinicians consider the differences in the two types of trauma when determining treatment approaches. A convenience sample of licensed trauma-oriented clinicians (N=108) completed an anonymous, self-administered survey online. Overall, results showed that clinician characteristics (e.g., experience and formal training, theoretical orientation, empirical literature, and supervisor consultation) were significantly more likely to influence treatment decisions then client factors (e.g., client's level of functioning, whether the client endorses suicidal ideation, the client has a traumatic brain injury, client's specific presenting symptoms, etc.). Treatment approaches were likely to be influenced by trauma descriptors that were interpersonal in nature (e.g., client killed a fellow soldier and client was assaulted by fellow soldier, client) and related to military values (e.g., client was unable to trust commanding officers and client was unable to trust fellow soldiers). Finally, clinicians who were randomly assigned to consider either a combat-related trauma vignette or a MST vignette did not differ in their selection of specific therapy techniques (e.g., prolonged exposure therapy vs. psychodynamic therapy). Taken together, these results suggest that psychological treatments for military trauma are not particularly dependent on the type of trauma but are strongly guided by the clinician's understanding of how to treat trauma in general and to some extent by particular contextual variables connected to the trauma. Future research should determine whether the variables embraced and ignored by trauma-clinicians are appropriate for optimizing trauma treatment outcomes.
Carreiro, Stefanie, "Clinician's treatment decisions for a combat-related trauma and military sexual trauma : a comparative study" (2014). Masters Thesis, Smith College, Northampton, MA.
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