Kathleen M. Grubbs's research while affiliated with VA San Diego Healthcare System and other places

Publications (32)

Article
Background Several efficacious psychological and pharmacological treatments for posttraumatic stress disorder (PTSD) are available; however, the comparative effectiveness of these treatments represents a major gap in the literature. The proposed study will compare the effectiveness of two leading PTSD treatments – Prolonged Exposure (PE) therapy an...
Article
Objective: This three-arm randomized trial tested a brief version of cognitive-behavioral conjoint therapy (bCBCT) delivered in two modalities compared to couples' psychoeducation in a sample of U.S. veterans with posttraumatic stress disorder (PTSD) and their intimate partners. Method: Couples were randomized to receive (a) in-person, office-ba...
Article
Objective To address barriers to trauma-focused psychotherapy for veterans with posttraumatic stress disorder (PTSD), we compared two implementation strategies to promote the deployment of telemedicine collaborative care. Method We conducted a Hybrid Type III Effectiveness Implementation trial at six VA medical centers and their 12 affiliated Comm...
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The goal of this study was to create simple visual displays to help patients understand the benefits of evidence‐based treatment for posttraumatic stress disorder (PTSD). We reviewed randomized trials of the most effective individual, trauma‐focused psychotherapies and first‐line antidepressants for adults with PTSD. The analytic sample included 65...
Article
Objective: Development of smartphone apps for mental health care has outpaced research on their effectiveness. This pilot study tested Moving Forward, an app designed to support problem-solving therapy (PST). Methods: Thirty-three veterans seeking mental health care in U.S. Department of Veterans Affairs primary care clinics were randomly assign...
Article
Leveraging technology to provide evidence‐based therapy for posttraumatic stress disorder (PTSD), such as prolonged exposure (PE), during the COVID‐19 pandemic helps ensure continued access to first‐line PTSD treatment. Clinical video teleconferencing (CVT) technology can be used to effectively deliver PE while reducing the risk of COVID‐19 exposur...
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For patients participating in trauma‐focused psychotherapies for posttraumatic stress disorder (PTSD), such as cognitive processing therapy (CPT), pretreatment characteristics may moderate treatment effectiveness. For instance, preexisting supportive relationships may encourage skill utilization or provide contrasts to maladaptive cognitive biases...
Article
The present study examined how the format in which treatment information is presented impacts individuals' preferences for posttraumatic stress disorder (PTSD) treatments. Adults who screened positive for PTSD (N = 301) were randomized into groups to learn about five first-line treatments; participants either read sequential text descriptions or re...
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Full-text available
Objective: This study examined clinical and retention outcomes following variable length prolonged exposure (PE) for posttraumatic stress disorder (PTSD) delivered by one of three treatment modalities (i.e., home-based telehealth [HBT], office-based telehealth [OBT], or in-home-in-person [IHIP]). Method: A randomized clinical trial design was us...
Article
Introduction Mental health treatment utilization among persons with posttraumatic stress disorder (PTSD) tends to be low but may be improved by aligning treatment with patient preferences. Our objective was to characterize the reasons that drive a person’s selection of a specific evidence-based PTSD treatment. Materials and Methods Data were colle...
Article
This study explored rates of non-attendance (i.e., non-initiation, inconsistent attendance, early discontinuation) in cognitive processing therapy (CPT) and other posttraumatic stress disorder (PTSD) focused individual and group psychotherapies (i.e., interventions with at least some PTSD and/or trauma-related content) and characterized veterans' s...
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Full-text available
Background Cognitive behavioural therapy (CBT) for panic disorder encourages patients to learn about and make changes to thoughts and behaviour patterns that maintain symptoms of the disorder. Instruments to assess whether or not patients understand therapy content do not currently exist. Aims The aim of this study was to examine if increases with...
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Full-text available
Interpersonal difficulties are common among veterans with posttraumatic stress disorder (PTSD) and are associated with poorer treatment response. Treatment outcomes for PTSD, including relationship functioning, improve when partners are included and engaged in the therapy process. Cognitive-behavioral conjoint therapy for PTSD (CBCT) is a manualize...
Article
Introduction Home-based delivery of psychotherapy may offer a viable alternative to traditional office-based treatment for post-traumatic stress disorder (PTSD) by overcoming several barriers to care. Little is known about patient perceptions of home-based mental health treatment modalities. This study assessed veterans’ preferences for treatment d...
Article
Introduction: Home-based delivery of psychotherapy may offer a viable alternative to traditional office-based treatment for posttraumatic stress disorder (PTSD) by overcoming several barriers to care. Little is known about patient perceptions of home-based mental health treatment modalities. This study assessed veterans’ preferences for treatment d...
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Full-text available
Trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) are not widely utilized. Clinicians report concerns that direct discussion of traumatic experiences could undermine the therapeutic alliance, which may negatively impact retention and outcome. Studies among adolescents with PTSD found no difference in alliance between trauma-fo...
Article
Objective: Collaborative care for depression results in symptom reduction when compared with usual care. No studies have systematically compared collaborative care outcomes between veterans treated at Veterans Affairs (VA) clinics and civilians treated at publicly funded federally qualified health centers (FQHCs) after controlling for demographic...
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Full-text available
Objective: Anger is a symptom of post-traumatic stress disorder (PTSD) associated with a range of clinical and functional impairments, and may be especially prevalent among veterans with PTSD. Effective anger management therapies exist but may be undermined by poor engagement or lack of treatment availability. Finding ways to engage veterans in an...
Article
Purpose: Community-Based Outpatient Clinics (CBOCs) provide primary-care-based mental health services to rural veterans who live long distances from Veterans Affairs (VA) hospitals. Characterizing the composition of usual care will highlight the need and potential strategies to improve access to and engagement in evidence-based psychotherapy for p...
Article
Collaborative care (CC) increases access to evidence-based pharmacotherapy and psychotherapy. The study aim was to identify the characteristics of rural veterans receiving a telemedicine-based CC intervention for posttraumatic stress disorder (PTSD) who initiated and engaged in cognitive processing therapy (CPT) delivered via interactive video. Vet...
Article
This study compares the mental health diagnoses of encounters delivered face to face and via interactive video in the Veterans Healthcare Administration (VHA). We compiled 1 year of national-level VHA administrative data for Fiscal Year 2012 (FY12). Mental health encounters were those with both a VHA Mental Health Stop Code and a Mental Health Diag...
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Full-text available
The aim of this study was to test whether gender moderates intervention effects in the Coordinated Anxiety Learning and Management (CALM) intervention, a 12-month, randomized controlled trial of a collaborative care intervention for anxiety disorders (panic disorder, generalized anxiety disorder, posttraumatic stress disorder, and social anxiety di...
Article
This study evaluated change in rural and urban veterans' psychotherapy use during a period of widespread effort within the Veterans Health Administration (VHA) to engage rural veterans in mental health care. National VHA administrative databases were queried for patients receiving a new diagnosis of depression, anxiety, or posttraumatic stress diso...
Article
Posttraumatic stress disorder (PTSD) is prevalent, persistent, and disabling. Although psychotherapy and pharmacotherapy have proven efficacious in randomized clinical trials, geographic barriers impede rural veterans from engaging in these evidence-based treatments. To test a telemedicine-based collaborative care model designed to improve engageme...
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Full-text available
Panic disorder commonly co-occurs in patients with chronic obstructive pulmonary disease (COPD), and translational interventions are needed to address the fear of physiological arousal in this population. This paper examines the utility of interoceptive exposures (IE), a key component of cognitive behavioral therapy (CBT) for panic disorder, in pat...
Article
Cognitive-behavioral therapy (CBT) is the treatment of choice for panic disorder (PD); however, the effectiveness of the treatment is often thought to be diminished in the presence of comorbid conditions. PD and posttraumatic stress disorder (PTSD) commonly co-occur in veteran populations, potentially complicating the effective treatment of each di...
Article
Therapist adherence to a manualized cognitive-behavioral anger management group treatment (AMT) was compared between therapy delivered via videoconference (VC) and the traditional in-person modality, using data from a large, randomized controlled trial comparing the effectiveness of AMT for veterans with combat-related posttraumatic stress disorder...
Article
Few studies have investigated the impact of deployment stressors on the mental health outcomes of women deployed to Iraq in support of Operation Iraqi Freedom. This pilot study examined exposure to combat experiences and military sexual harassment in a sample of 54 active duty women and assessed the impact of these stressors on post-deployment post...
Article
Video teleconferencing (VTC) is used for mental health treatment delivery to geographically remote, underserved populations. However, few studies have examined how VTC affects individual or group psychotherapy processes. This study compares process variables such as therapeutic alliance and attrition among participants receiving anger management gr...

Citations

... Research has shown that interventions addressing dyads can reliably improve DS and may be useful in this regard, but they should be tailored to the unique needs of MFCs, who are often different from their civilian counterparts. 45,46 For example, one study on caregivers using a psycho-education intervention for dyads (caregiver and care recipient) found positive effects on mental, emotional, and functional HOs, as well as on self-efficacy. 47 Likewise, on the basis of research supporting direct links between social support and DS, 17 behavioural interventions targeting mental HOs might consider incorporating strategies for enhancing social support and support networks. ...
... La TCT realizada de forma combinada: presencial-telemática, ha resultado efectiva para tratar el trastorno de estrés postraumático de esta paciente. Este formato podría permitir más flexibilidad para los pacientes y mejor cumplimiento terapéutico al no tener que desplazarse a la clínica correspondiente, siempre que se sigan rigurosamente las recomendaciones clínicas y adaptaciones que proporciona la literatura científica para las intervenciones telemáticas en pacientes con TEPT (13,14,15). Como limitación al caso presentado, estaría la falta de pruebas objetivas de evaluación y de evolución clínica y se sugiere, en futuras intervenciones, realizar más pruebas objetivas a través de cuestionarios validados científicamente en tres momentos del tratamiento: inicio, mitad y fin del mismo. ...
... Thus, gender may serve as an initial indicator for treatment targets, whereby a clinician can bolster such skills for those experiencing greater PTSS. Finally, emphasizing resiliency skills, which is integral when encountering traumatic events (Campbell et al., 2020;Carmassi et al., 2020), through early intervention reinforces social and emotional outcomes in addition to PTSS (Richins et al., 2020;Vranceanu et al., 2020). These results highlight the differences in benefits that male and female informal caregivers receive from resiliency factors, which can inform the delivery of interventions to promote coping and prevent chronic PTSS. ...
... The Harik et al. (2020) paper appeared in the JTS, which is published by the International Society for Traumatic Stress Studies (ISTSS), and consequently not only has significant reach, but also important political influence in defining international treatment guidelines for PTSD and complex PTSD. The retraction was sought by the authors, not the Editor. ...
... Post-traumatic stress disorder (PTSD) is a highly prevalent condition [1] and a pervasive and persistent mental disease, The main feature of PTSD includes nightmares, personality changes, emotional dissociation, that trigger traumatic memories, irritability, memory loss, being easily frightened and there are some flashlight in their minds. It is because of terrible or impressive experiences or to react to major stress. ...
... We define telehealth as the use of phone (audio-only) or videoconferencing to deliver synchronized, real-time care to patients, and include articles on using either of these modalities for mental health treatments. Studies that brought patients into a clinic and then connected them to a remotely located provider [13][14][15] are also included and treated as video studies. Studies on internet-based treatments, mobile apps, email, or instant messaging were not included. ...
... A full paper review was conducted on 253 papers, and 12 articles were selected for inclusion (see Figure 1). Details of the 12 included studies [29][30][31][32][33][34][35][36][37][38][39][40] are summarized in Table 1. ...
... The study protocol was approved by the Institutional Review Board of the University of California, San Diego, and this study's design and hypotheses were preregistered; see Trial Registration: NCT02720016. The study methods have been published (Morland et al., 2019). ...
... While the relationship between gender and mental health has been somewhat outlined in CWs and other PSP, future research needs to consider how the other demographic factors impact the different facets of care. A systematic review included in this review highlighted the importance of examining gender, racial, and cultural factors when designing digital mental health interventions for PSP since they may result in differential outcomes, preferences, and needs (26,134,135). ...
... In research assessing brain age-related to posttraumatic stress disorder (PTSD), Veterans Administration researchers modeled Veterans as having an active military status and as patients actively seeking treatment in the Veterans Administration Health Care System (Clausen et al., 2022). Chen et al. (2020) researched therapeutic alliance across trauma-focused psychotherapies among Veterans with PTSD. This VA study modeled Veterans only as those eligible for the Veterans Administration Health Care System. ...