Treatment Efforts for Returning War Veterans
Evidence-based psychotherapies for treating post traumatic stress disorder (PTSD) among veterans.
Using funds awarded from the American Recovery and Reinvestment Act of 2009, Joan Cook, Ph.D. and colleagues from Yale University will be evaluating the implementation of two evidence based treatments of PTSD will be evaluated.
The grant addresses the NIH Challenge Grant topic "Strategies to Support Uptake of Interventions within Clinical Community and Settings." As the numbers of soldiers more soldiers returning from Iraq and Afghanistan struggle with this disorder, strategies for promoting evidence-based PTSD treatments in the military are urgently needed.
The Department of Veterans Affairs (VA) residential PTSD treatment will asses the implementation of two therapy types:
- PE-prolonged exposure (PE) therapy.
In prolonged exposure therapy the goal is to have less fear about your memories. It is based on the idea that people learn to fear thoughts, feelings, and situations that remind them of a past traumatic event. By talking about your trauma repeatedly with a therapist, you'll learn to get control of your thoughts and feelings about the trauma. You'll learn that you do not have to be afraid of your memories.
This may be hard at first. It might seem strange to think about stressful things on purpose. But you'll feel less overwhelmed over time. With the help of your therapist, you can change how you react to the stressful memories. Talking in a place where you feel secure makes this easier. You may focus on memories that are less upsetting before talking about worse ones. This is called "desensitization," and it allows you to deal with bad memories a little bit at a time.
Your therapist also may ask you to remember a lot of bad memories at once. This is called "flooding," and it helps you learn not to feel overwhelmed. You also may practice different ways to relax when you're having a stressful memory. Breathing exercises are sometimes used for this.
- CPT-cognitive processing therapy.
In cognitive therapy, your therapist helps you understand and change how you think about your trauma and its aftermath. Your goal is to understand how certain thoughts about your trauma cause you stress and make your symptoms worse. You will learn to identify thoughts about the world and yourself that are making you feel afraid or upset. With the help of your therapist, you will learn to replace these thoughts with more accurate and less distressing thoughts. You also learn ways to cope with feelings such as anger, guilt, and fear. After a traumatic event, you might blame yourself for things you couldn't have changed. For example, a soldier may feel guilty about decisions he or she had to make during war.
Cognitive therapy, a type of CBT, helps you understand that the traumatic event you lived through was not your fault.
Study partners are: Northeast Program Evaluation Center and the National Center for PTSD. Using online questionnaires, semi-structured interviews and on-site observations, the efforts of more than 250 mental health providers in residential PTSD treatment settings will be monitored and evaluated.
Specific scientific and health research challenges in biomedical and behavioral research will benefit from an influx of funds from the
American Recovery and Reinvestment Act of 2009 (Recovery Act).
Approximately thirty-five topics of interest regarding funding can be found at
NIMH's Challenge Grant web page. Also see:
NIMH Strategic Plan NIH Challenge Grants in Health and Science Research Trans-NIH Plan for HIV-Related Research National Advisory Mental Health Council report on research training.
Other therapy types:
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant medicine. These can help you feel less sad and worried. They appear to be helpful, and for some people they are very effective.
SSRIs include citalopram (Celexa), fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft). Chemicals in your brain affect the way you feel. When you have or depression you may not have enough of a chemical called serotonin. SSRIs raise the level of serotonin in your brain.
Eye movement desensitization and reprocessing (EMDR) is a fairly new therapy for PTSD. Like other kinds of counseling, it can help change how you react to memories of your trauma. While talking about your memories, you'll focus on distractions like eye movements, hand taps, and sounds.
For example, your therapist will move his or her hand near your face, and you'll follow this movement with your eyes. Experts are still learning how EMDR works. Studies have shown that it may help you have fewer PTSD symptoms. But research also suggests that the eye movements are not a necessary part of the treatment.
Group therapy, Psychodynamic psychotherapy, Family therapy.
Seal, K., Metzler, T., Gima, K., Bertenthal, D., Maguen, S., & Marmar, C. (2009). Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002-2008American Journal of Public Health, 99 (9), 1651-1658 DOI: 10.2105/AJPH.2008.150284 
