Tag Archives: Treatment for PTSD

Post Traumatic Stress Disorder (PTSD) Is Treatable

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San Diego artists stop to appreciate one of the paintings featured in the Combat Arts exhibit in the Southwestern University art gallery, featuring art by Iraq and Afghanistan war veterans with post-traumatic stress. (Sgt. Ken Scar/Army)

MILITARY TIMES

“Warrior Care Network Academic Medical Center (AMC) partners at Emory University, Massachusetts General Hospital, Rush University, and UCLA Health use tailored combinations of evidence-based, complementary, and alternative therapies.

Veterans who are struggling to do a brave thing — seek care because PTSD is treatable and treatment works.”

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“A recent study conducted by researchers at the New York University and published in the Journal of the American Medical Association (JAMA) has led many to believe the leading evidence-based psychotherapies for post-traumatic stress disorder do not work for up to two-thirds of patients.

Our findings at Wounded Warrior Project (WWP) show very different results for veterans participating in our two- and three-week intensive outpatient programs (IOP) provided by our Warrior Care Network Academic Medical Center (AMC) partners at Emory University, Massachusetts General Hospital, Rush University, and UCLA Health. They all use tailored combinations of evidence-based, complementary, and alternative therapies within their IOP.

Under our IOP, veterans receive upwards of 70 hours of direct clinical care — more than a year’s worth of traditional therapy.

For the almost 2,000 veterans who have completed IOP with the Warrior Care Network, the results are extremely promising.

Veterans completing IOP show a clinically significant reduction in PTSD symptoms (measured using the PCL-5), and these lower levels are relatively sustained 12 months following treatment.

This decreased symptomology tends to result in increased functioning — empowering veterans to more actively engage in life.

Remarkably, our IOP program has a greater than 90 percent completion rate — double the national average. We believe this is due to a variety of factors including the condensed time period (two to three weeks), our cohort model where small groups of veterans start the program together and graduate together, and the inclusion of evidence-based therapies with alternative and complimentary therapies.

While we appreciate the discussion generated by the JAMA article on the challenges of delivering mental health care and the need for future research and better treatment models, we are concerned about the researchers’ approach of collapsing veterans’ results within active-duty military and civilian results due to wide variations in cultural characteristics and treatment goals and methods.

While mental health care challenges are a global issue, it is important to remember that the military is a collectivist culture that places the group and mission over the needs of the individual. This dynamic, combined with the potential for increased and prolonged exposure to traumatic events, may increase service members’ risk for specific mental health challenges.

These cultural differences are compounded when military members leave active duty following inadequate transition assistance support programs and begin assimilating back into civilian culture. Many veterans may feel isolated during this period and struggle with their mental health as they attempt to find their new cultural identities and reengage in civilian life.

Even within the military community, treatment goals, results, and completion rates differ between the active-duty and veteran populations and the broader civilian population.

Our outcomes and results treating veterans seems to outpace other methods in clinical reduction of depression and PTSD, overall completion rates, and patient satisfaction scores.

Differences between active-duty service members and veterans may be driven by desired outcomes. For instance, active-duty members may be more interested in managing symptoms of PTSD so they can continue their careers effectively. Whereas, veterans may tend to be more interested in symptom reduction, thereby increasing functionality, and reducing the impact on their families.

Countless articles and studies in the multicultural psychology field have warned against comparing minority, veterans in this case, with majority groups, such as civilians, as results may serve to further normalize the majority group culture.

Comparing military and veteran to civilian results may only further highlight the differences in the smaller military population when compared with the larger U.S. population.

There exists a large body of research that indicates that evidence-based treatment does work, however the effect tends to vary at the individual level.

To better determine which therapies work best for individuals, WWP invested in and is promoting research into biomarkers for PTSD.

With better understanding of these biomarkers, medical experts will be better able to tailor current therapies to individual patients and develop new models of care.

Until we gain a better understanding of individual differences in reacting to and recovering from trauma, we advocate for combining evidence-based therapies with complementary and alternative methods in an intensive outpatient format.

In conclusion, we welcome and support the need for further dialogue, discussion, research and innovation in the field of PTSD treatment, but suggest caution in how findings are disseminated and interpreted.

It falls on researchers and community partners to ensure that the dissemination of results provide both realistic expectations of treatment and refrain from creating additional barriers to care.

Most importantly, we strongly urge veterans who are struggling to do a brave thing — seek care because PTSD is treatable and treatment works.

https://www.militarytimes.com/opinion/commentary/2020/02/14/wounded-warrior-project-ptsd-is-treatable-and-treatment-works/

Revising U.S. PTSD Treatment Guidelines

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KevlarForTheMind

“MILITARY TIMES”

“Post-traumatic stress disorder is arguably the most challenging problem combat veterans face.

Medications need to be identified as “second-line” treatments. They should only be used if an effective talk therapy is not available.

Estimates vary, but experts believe that between 10 and 20 percent of Iraq and Afghanistan veterans suffer from the disorder. This puts the actual number of men and women affected in the hundreds of thousands.

Considering that PTSD wreaks havoc on the veteran and their loved ones, and costs billions of dollars each year, finding and using the most effective treatments are critical.

Historically, medications and talk therapy have been considered “first-line treatments.” This basically means they should be used first, and if they fail, then you try something else.  In fact, the joint treatment guidelines published by the Department of Defense and Veterans Affairs Department puts medications and psychotherapy on equaling footing. The same is true for the American Psychiatric Association.

Not all agree.

Organizations from the United Kingdom and Australia and the World Health Organization take the position that trauma-focused psychotherapies such as prolonged exposure, cognitive processing therapy, and eye movement desensitization and reprocessing are most effective when it comes to PTSD treatment. Basically, their stance is that the evidence for meds is just not as strong. A recent study carried out by military and VA researchers, and published in the journal Depression and Anxiety, supports this position.

After weeding through more than 60,000 possibilities, the researchers identified 55 psychotherapy and medication studies for PTSD. This added up to around 6,300 total study participants.

What did they find? Trauma-focused psychotherapies outperformed psychotherapies that do not specifically discuss the trauma. They also beat out medications.

This does not mean other psychotherapies are useless. For example, the researchers noted that stress inoculation training is effective for PTSD. SIT is a credible talk therapy that has been around for decades. It just may not be as effective as the trauma-focused therapies.

The same is true for medications. Zoloft and Effexor are commonly used for PTSD, and they do work for some people. But again, they may not be as useful as certain psychotherapies.

The results of this study challenge the current status quo with regard to treating our combat veterans. It is time to take a close look at how we prioritize PTSD treatments and make adjustments to our national treatment guidelines as necessary.”

http://www.militarytimes.com/story/military/advice/kevlar-for-the-mind/2016/05/15/us-needs-revisit-our-ptsd-treatment-guidelines/84323812/