New PTSD program answers need
By Capt. Bryan Lewis
LANDSTUHL REGIONAL MEDICAL CENTER, Germany (July 21, 2009) -- Symptoms of combat stress and post-traumatic stress disorder include continual nightmares, avoidance behaviors, denial, grief, anger and fear.
Some Soldiers, battling these and other symptoms, can be treated successfully as an outpatient while assuming their normal duties. For others, however, returning to work and becoming their old selves again were challenges recognized by several mental health professionals across the European theater.
"We were looking at how we can best meet the needs of our clientele, and we were identifying that a lot of the Soldiers needed more than once-a-week outpatient, individual therapy and probably needed more than once- or twice-a-week group therapy," said Joseph Pehm, chief of Medical Social Work at Landstuhl Regional Medical Center.
The solution came in the creation of an intensive eight-week therapeutic Post-Traumatic Stress Disorder Day Treatment Program called "evolution" that began in March 2009 at LRMC. During the eight-hour days, patients enrolled in the program participate in multiple disciplines and interests, including art therapy, yoga and meditation classes, substance abuse groups, anger and grief management, tobacco cessation, pain management and multiple PTSD evidence-based practice protocols.
"I am a great believer in the kitchen sink, meaning I throw everything, including the kitchen sink, and something will stick," said Dr. Daphne Brown, chief of the Division of Behavioral Health at LRMC. "And so we've come with all the evidence-based treatment for PTSD that we know about ... We've taken everything that we can think of that will be of use in redirecting symptoms for these folks and put it into an eight-week program."
Though few have completed this young program, signs of success have already started to surface.
"With the last group, the shift from 'I have to be here' to 'I'm so glad I came' was really phenomenal," said Pehm.
"One of them said that he didn't think he was getting anything out of the program," Brown said. "It was about week six until he saw himself react differently to a situation that came up, and watched himself do it differently using skills that he didn't know he learned. He went 'Wow,' maybe I am getting something out of this."
It is too early, and the numbers are too small, to generalize the early trends, but self-completed PTSD checklists showed a significant decrease in reported symptoms for three of the four patients in the first cohort. Additionally, anxiety and depression symptom measures decreased.
"The whole idea is that we know all the changes aren't going to take place here," said Brown. "But we hope we give them enough learning to send them in a different direction. My hope is that we can build a program to provide valid, effective treatment to folks who have put themselves in harm's way at the request of their country, and help them live happier and better lives."
There's much more at the link.