Treatment For Posttraumatic Stress Disorder In Military And Veteran Populations

Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq, but it affects veterans of all eras. It is estimated that 7-20% of service members and veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom may have the disorder. PTSD is characterized by a combination of mental health symptoms - re-experiencing of a traumatic event, avoidance of trauma-associated stimuli, adverse alterations in thoughts and mood, and hyperarousal - that last at least 1 month and impair functioning. PTSD can be lifelong and pervade all aspects of a service member's or veteran's life, including mental and physical health, family and social relationships, and employment. It is often concurrent with other health problems, such as depression, traumatic brain injury, chronic pain, substance abuse disorder, and intimate partner violence. The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide a spectrum of programs and services to screen for, diagnose, treat for, and rehabilitate service members and veterans who have or are at risk for PTSD. The 2010 National Defense Authorization Act asked the Institute of Medicine to assess those PTSD programs and services in two phases. The Phase 1 study, Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment, focused on data gathering. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment is the report of the second phase of the study. This report analyzes the data received in Phase 1 specifically to determine the rates of success for each program or method. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment considers what a successful PTSD management system is and whether and how such a system is being implemented by DoD and VA. This includes an assessment of what care is given and to whom, how effectiveness is measured, what types of mental health care providers are available, what influences whether a service member or veteran seeks care, and what are the costs associated with that care. This report focuses on the opportunities and challenges that DoD and VA face in developing, implementing, and evaluating services and programs in the context of achieving a high-performing system to care for service members and veterans who have PTSD. The report also identifies where gaps or new emphases might be addressed to improve prevention of, screening for, diagnosis of, and treatment and rehabilitation for the disorder. The findings and recommendations of Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment will encourage DoD and VA to increase their efforts in moving toward a high-performing, comprehensive, integrated PTSD management strategy that addresses the needs of current and future service members, veterans, and their families.

Authored by “the” foremost expert on providing EMDR therapy to the military/veteran population! Based on the profound expertise of the author—an EMDR therapist, consultant, and trainer who brings 33 years of military experience to his therapeutic work—this is a “how-to” manual on the unique treatment needs of active duty and veteran populations and how to help them using EMDR therapy. Following an examination of the defining characteristics and philosophy of military culture as they bear on effective therapeutic treatment, the book comprehensively applies the EMDR model to the active military/veteran population with a variety of presenting issues. Considering the clinical challenges of treating a population with repeated exposure to life-threatening experiences, moral injury, sexual assault, and other potentially debilitating trauma, the book addresses skill development, specific to EMDR treatment in detail. This go-to manual covers all the steps and processes of EMDR treatment from introducing EMDR therapy to the client to developing a sense of safety in the treatment arena. Allowing therapists trained in EMDR therapy to appropriately assess and address the clinical needs of the veteran by treating clients with both PTSD and traumatic brain injury; along with moral injury, military sexual trauma (MST), or suicidal ideation by recognizing and addressing avoidance and building motivation for treatment and treatment pitfalls. Case examples address clinical “stuck” points and a variety of treatment options when addressing a broad range of symptoms. The EMDR AIP model is incorporated into each case illustrating the veteran’s treatment goal, presenting symptoms, targeted memories, and clinical decision points in treatment. The print version of the book is also available in ebook format. Key Features: Addresses step-by-step EMDR skill development specific to this population Incorporates the EMDR eight-phase approach Delivers abundant case examples enhanced with clinical treatment options Includes a paradigm for evaluating the military and veteran’s initial clinical presentation Discusses treatment for clients with PTSD, traumatic brain injury, moral injury, sexual trauma, and suicidal ideation Considers the treatment needs of the military family · Includes a variety of helpful patient handouts

This book takes a case-based approach to addressing the challenges psychiatrists and other clinicians face when working with American combat veterans after their return from a war zone. Written by experts, the book concentrates on a wide variety of concerns associated with posttraumatic stress disorder (PTSD), including different treatments of PTSD. The text also looks at PTSD comorbidities, such as depression and traumatic brain injury (TBI) and other conditions masquerading as PTSD. Finally, the authors touch on other subjects concerning returning veterans, including pain, disability, facing the end of a career, sleep problems , suicidal thoughts, violence, , and mefloquine “toxidrome”. Each case study includes a case presentation, diagnosis and assessment, treatment and management, outcome and case resolution, and clinical pearls and pitfalls. Post-Traumatic Stress Disorder and Related Diseases in Combat Veterans is a valuable resource for civilian and military mental health practitioners, and primary care physicians on how to treat patients returning from active war zones.

Mental disorders, including posttraumatic stress disorder (PTSD), constitute an important health care need of veterans, especially those recently separated from service. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence takes a systematic look the efficacy of pharmacologic and psychological treatment modalities for PTSD on behalf of the Department of Veterans Affairs. By reviewing existing studies in order to draw conclusions about the strength of evidence on several types of treatment, the Committee on the Treatment of Posttraumatic Stress Disorder found that many of these studies were faulty in design and performance, and that relatively few of these studies have been conducted in populations of veterans, despite suggestions that civilian and veteran populations respond differently to various types of treatment. The committee also notes that the evidence is scarce on the acceptability, efficacy, or generalizability of treatment in ethnic and cultural minorities, as few studies stratified results by ethnic background. Despite challenges in the consistency, quality, and depth of research, the committee found the evidence sufficient to conclude the efficacy of exposure therapies in treating PTSD. The committee found the evidence inadequate to determine efficacy of different types of pharmacotherapies, of three different psychotherapy modalities, and of psychotherapy delivered in group formats. The committee also made eight critical recommendations, some in response to the VA's questions related to recovery and the length and timing of PTSD treatment, and others addressing research methodology, gaps in evidence and funding issues.

In response to growing national concern about the number of veterans who might be at risk for posttraumatic stress disorder (PTSD) as a result of their military service, the Department of Veterans Affairs (VA) asked the Institute of Medicine (IOM) to conduct a study on the diagnosis and assessment of, and treatment and compensation for PTSD. An existing IOM committee, the Committee on Gulf War and Health: Physiologic, Psychologic and Psychosocial Effects of Deployment-Related Stress, was asked to conduct the diagnosis, assessment, and treatment aspects of the study because its expertise was well-suited to the task. The committee was specifically tasked to review the scientific and medical literature related to the diagnosis and assessment of PTSD, and to review PTSD treatments (including psychotherapy and pharmacotherapy) and their efficacy. In addition, the committee was given a series of specific questions from VA regarding diagnosis, assessment, treatment, and compensation. Posttraumatic Stress Disorder is a brief elaboration of the committee's responses to VA's questions, not a detailed discussion of the procedures and tools that might be used in the diagnosis and assessment of PTSD. The committee decided to approach its task by separating diagnosis and assessment from treatment and preparing two reports. This first report focuses on diagnosis and assessment of PTSD. Given VA's request for the report to be completed within 6 months, the committee elected to rely primarily on reviews and other well-documented sources. A second report of this committee will focus on treatment for PTSD; it will be issued in December 2006. A separate committee, the Committee on Veterans' Compensation for Post Traumatic Stress Disorder, has been established to conduct the compensation study; its report is expected to be issued in December 2006.

This document provides information on post-traumatic stress disorder (PTSD) and war-related stress for veterans & their families. It begins with background on PTSD and traumatic events, then describes common symptoms of PTSD and why they develop. The next section reviews problems associated with PTSD, such as depression, anxiety, and impacts on work & family. The final sections provide suggestions on coping with the disorder and describe treatment methods.

The culmination of more than 25 years of clinical work and research, this is the authoritative presentation of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD). Written by the treatment's developers, the book includes session-by-session guidelines for implementation, complete with extensive sample dialogues and 40 reproducible client handouts. It explains the theoretical and empirical underpinnings of CPT and discusses how to adapt the approach for specific populations, such as combat veterans, sexual assault survivors, and culturally diverse clients. The large-size format facilitates photocopying and day-to-day use. Purchasers also get access to a Web page where they can download and print the reproducible materials. CPT is endorsed by the U.S. Departments of Veterans Affairs and Defense, the International Society of Traumatic Stress Studies, and the U.K. National Institute for Health and Care Excellence (NICE) as a best practice for the treatment of PTSD.

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.