In particular, cognitive-behavioral therapy has received substantial research to support its effectiveness as an intervention strategy. Yet those interventions that combined psychotherapy and medications have been proven to be the most effective in the military culture. However, the recommendation to consider medication management may be met with resistant by the individual and should be explored in a manner that allows the individual to feel empowered (Silver, Brooks, & Obenchain, 1995). Interventions that occur early on in the symptomatic process can also result in fewer individuals developing PTSD.
In order to successfully treat the post-combat individual, a clinician utilizing CBT needs to be able to assist the individual in identifying the role that their coping strategies played in keeping them safe and stable during deployment and in combat situations (Owens et al., 2009). Despite the positive role that these strategies played in survival, these maladaptive coping strategies often make community reintegration difficult. Successful integration will require that family, friends, and community members are not only engaged in the treatment process but are also respected for the crucial contributions that they make to the integration process.
Individuals returning from combat may be at different points in their readiness to engage in treatment. It will be important for the clinician to create a safe environment as well as meeting the client where they are at in terms of readiness to process the trauma experienced in combat. This individual will need clear cut short-term objectives and goals so that they can experience success and utilize this to frame future progress. Suicidality must be evaluated on an ongoing basis with the client understanding that the clinician in mandated to report dangerousness to self to the appropriate authorities.
The identification...
The identification of the link between addictive behaviors and exposure to trauma may help the individual recognize the self-medication process and allow them to be more receptive to psychotropic medications.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.
Owens, G.P., Dashevsky, B., Chard, K.M., Mohamed, S., Haji, U., Heppner, P.S., & Baker, D.G., (2009). The relationship between childhood trauma, combat exposure, and posttraumatic stress disorder in male veterans. Military Psychology, 21(1), 114-125.
Seal, K.H., Metzler, T.J., Gima, K.S., Bertenthal, D., Maguen, S., & Marma, C.R. (2009). Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002-2008. American Journal of Public Health, 99(9), 1651-1658. doi: 10.2105/AJPH.2008.150284
Silver, S., Brooks, A., & Obenchain, J. (1995). Treatment of Vietnam War Veterans with PTSD: A Comparison of Eye Movement Desensitization and Reprocessing, Biofeedback, and Relaxation Training. Journal of Traumatic Stress, 8(2), 337-342.
Wells, T.S., LeardMann, C.A., Fortuna, S.O., Smith, B., Smith, T.C., Ryan, M.A., Boyoko, E.J., & Blazer, D. (2010). A prospective study of depression following combat deployment in support of the wars in Iraq and Afghanistan. American Journal of Public Health, 100(1), 90-99. doi: 10.2105/AJPH.2008.155432
