Stress Inoculation Training Outcomes Among Veterans With PTSD and TBI

Objective: Stress inoculation training (SIT) is a cognitive-behavioral treatment that has demonstrated potential as a nontrauma based intervention for veterans with posttraumatic stress disorder (PTSD). The purpose of this study was to explore the efficacy of a novel 3-phase group formulation of SIT applied to a naturalistic population of veterans with PTSD and traumatic brain injury (TBI). The goals were to reduce symptoms of PTSD and depression, improve perceived functioning, and increase treatment initiation among veterans who were reticent to initiate established evidence-based and trauma-focused therapies. Method: A program development and evaluation archival analysis of 65 veterans engaged in SIT over an 18-month period at an outpatient VA PTSD clinic was conducted. Participants completed baseline self-report measures of PTSD and depression symptoms, substance use, and perceived performance. Results: Paired samples t tests were used to evaluate pre- to posttreatment gains and demonstrated significant reductions in PTSD (PTSD Checklist, d = 0.66) and depression symptoms (Beck Depression Inventory, d = 0.67), increases in aspects of perceived stress tolerance and performance in multiple life domains, as well as improvements in both social and occupational functioning (Situational Adaptation to Stress Scale, d = 1.26). Eighty-eight percent of the intent-to-treat sample followed through with the recommended follow-up treatment. Conclusions: The results of this study provide preliminary support for the use of this SIT protocol in reducing symptoms of PTSD and depression, improving performance, and increasing rates of treatment initiation in evidence-based and trauma-focused treatments.