Perspectives on a Stage-Based Treatment for Posttraumatic Stress Disorder Among Dialectical Behavior Therapy Consumers in Public Mental Health Settings

Difficulties with consumer engagement are a common barrier to implementing trauma-focused evidence-based psychotherapies (TF-EBPs). Potential methods of increasing engagement include utilizing a stage-based treatment approach, and involving consumers in implementation efforts. This mixed method study explored consumers’ perspectives on a stage-based TF-EBP, Dialectical Behavior Therapy (DBT) with the DBT Prolonged Exposure (DBT PE) protocol. Nineteen DBT consumers in two public mental health agencies targeted for implementation of DBT + DBT PE participated in focus groups and completed questionnaires assessing treatment preferences and expectancies. Consumers reported positive treatment expectancies and a strong preference for DBT with DBT PE (89.5%) over DBT alone (5.3%) or PE alone (5.3%). This was primarily due to beliefs about the treatment’s efficacy, a perceived need for PTSD treatment, and the stage-based approach. Consumer-focused strategies for increasing uptake and reach of TF-EBPs are discussed.