PTSD Inroduction Posttraumatic Stress Disorder

PTSD

Inroduction

Posttraumatic stress disorder (PTSD) is a major problem among U.S. This is especially the case as long and even multiple deployments for active duty and reserve troops are common in the war on terror.

Many therapy approaches have been tried to treat or prevent PTSD. The cognitive model of therapy is increasingly being used in an attempt to literally talk the soldiers out of their problems and to help them understand and modify their thinking on the subject. Then, they can return their lives to a center and balance that they would not have otherwise.

Article Summary and Cognitive Behavioral Therapy

In Approaches to the Primary Prevention of Posttraumatic Stress

Disorder in the Military: A Review of the Stress Control Literature

by Laurel L. Hourani, Carol L. Council, Robert C. Hubal and Laura B. Strange, data was collected and analyzed from clinical studies and also data collected from surveys given to combat troops, to determine the best treatment options for those troops diagnosed with PTSD. However, little is known about how effective predeployment training is in preventing or minimizing the impact of combat-related stressors on the development of PTSD. The authors of the journal article conducted an exhaustive review of literature that concerned the primary prevention efforts to prevent PTSD as well as other combat and operational stress injuries in military populations. To do this, databases were used, peer-reviewed literature was use, and the article made use of online searches and colleague referrals.

The results reveal that the most promising preventive approaches in the fight against PTSD seem to use exposure strategies using education and stress reduction skills training in the field of cognitive behavioral therapy.

By developing a systematized approach, researchers hope to be more systematic in their treatment of PTSD. Something akin to this was documented in the training and was called "mobile narratives." These stress prevention exercises were delivered via cell phones. By doing this, soldiers experiencing combat stress could relax by engaging in audio-visual experiences

Such an approach would have many advantages, including treating the soldier close to the incidents triggering the PTSD, indeed while the solder is still in the combat zone. This was be very useful because the soldier could engage in the therapy immediately before going out on a mission or immediately after to help them deal with the stress.

The article indicated that efforts are also being made in the predeployment phase to introduce cognitive behavior treatments. However such individuals that reported favorable results from such efforts tended to be upbeat individuals who were better able to deal with stress anyway. While such approaches have worked in the private sector in preparing patients for dental or medical treatments, the results are as yet inconclusive for military personnel (ibid, 726). Another approach is to target troops that are prone to PTSD prior to deployment to a war zone. Presently, the information about such efforts are inconclusive (ibid).

Precombat educational briefings to reduce soldier anxiety and to increase stress coping skills. These include such programs as the Army's Battlemind and the Navy and Marines' COSC programs

. The results for Battlemind are inconclusive as of yet. COSC is geared to training command (officers/NCO's) to be able identify PTSD 3-6 months prior to deployment. This military program also has not produced definitive results either for evaluation (ibid, 726-727). Of course, studies have shown that the longer the deployment and the increase in the stress of the deployment increases the incidence of PTSD (ibid, 727).

Predeployment training has generally has focused on briefings that speak about the stressors related to operations, such as simple methods for managing stress (in oneself and others),

and information concerning when and how to access additional support in the fight against PTSD. Variance in the effectiveness of social support services and exposure to life-threatening events accounts or a high amount of variance in PTSD severity. The Psychoeducational and coping skills training prevention efforts have been

The authors suggest that these efforts were helpful (ibid, 726).

What struck the author profoundly was the emphasis of the military upon multimedia types of information packages or briefing materials. In other words, the military approach is very high tech. For whatever reason, simple talking through of PTSD related issues and incidents is relatively rare and needs support to keep such programs going. Perhaps soldiers identify with another human being who has gone through what they have and have little time for a "talking head" on a video. Their experiences emphasize the importance of human contact. They enjoy such intimacy with their comrades in arms and expect the same respect and comradery form mental health and counseling professionals.

However, the literature review that was available in the article was more positive with regard to this. A 2009 study was referenced that used debriefing as a treatment regimen. In this program, the debrief uses a specific set of questions used to guide participants to acknowledge the events of combat they experienced and then review them, emphasizing the stressors involved (ibid, 725). Additionally, a 2007 survey polled individual contacts outside of a treatment clinic, of which the visits were in order to deal with PSTD or other psychiatric disorders (ibid, 723). Again, talking about the issues experienced in combat or in stressful situations seemed to this author to have provided the most tangible and effective results, at least in the opinions of the soldiers. Logically, these should be the opinions that matter the most in terms of validity.

It is interesting to note that on the United States Department of Veteran's Affairs, cognitive behavioral therapy is one two type of counseling. The page advises that "it appears to be the most effective type of counseling for PTSD" ("Treatment of ptsd," 2010) . It goes on to advise that the therapist will help the service member 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 will also learn ways to cope with feelings such as anger, guilt, and fear" (ibid). In essence, at the top of advised treatments for veterans is a type of treatment that involves empowering them in the effort to help them deal more effectively with PTSD.