VA program helps veterans, military personnel manage chronic PTSD

NEW YORK — A team of experts from the Miami VA Healthcare System and the University of Miami Miller School of Medicine discussed an evidence-based collaborative care model used to treat veterans with chronic military-related PTSD in a poster presented here.

For the last 3 decades, the Miami VA PTSD Clinic has provided evidence-based individual and group psychotherapy and pharmacotherapy to veterans with chronic military-related PTSD to help them better manage their symptoms, achieve remission and improve function. In the last 16 years, the number of active patients at the Miami VA PTSD Clinic increased from 519 in 2002 to a high of 3,021 in 2014, before decreasing to 2,525 in 2017. There are currently about 200 other specialty PTSD programs distributed across the VA Healthcare network.

“PTSD is very common among veterans and about 30% of cases follow a chronic course,” Nils C. Westfall, MD, a psychiatry resident at Jackson Memorial Hospital and the University of Miami Miller School of Medicine, told Healio Psychiatry. “The purpose of the specialty PTSD program at the Miami VA is to ensure that affected veterans always have ready access to the best evidence-based treatment for chronic PTSD.”

The program educates patients about their condition and potential treatments and involves them in the decision-making process to develop a multimodal, collaborative treatment plan integrating management of comorbid diagnoses, psychosocial stressors, family dynamics, and other factors affecting safety, treatment outcomes, and quality of life.

Each patient works with the PTSD Clinic team to select the evidence-based individual or group psychotherapies that will best address his or her unique treatment goals. Individual therapy could include cognitive processing therapy, prolonged exposure, acceptance and commitment therapy for depression, cognitive behavioral therapy for depression and insomnia, dialectical behavioral therapy and motivational interviewing. Group therapies provide psychoeducation about PTSD and closely related topics, teach coping skills and mindfulness and focus on clinical problems including depression, substance use, military sexual trauma, anger management, ineffective interpersonal communication and insomnia. Couples therapy is also available to address the many ways that PTSD can affect a veteran’s closest relationship.

“Most clinicians do not get substantial training in or regularly practice trauma-focused therapies and it is a very challenging area of work. To make skilled delivery of these evidence-based therapies for PTSD accessible on-demand as our veterans deserve, you really need a specialized clinic,” Westfall told Healio Psychiatry.

“We believe that having a program like this is critical to ensure that veterans receive state-of-the-art, comprehensive, integrated, and personalized evidenced-based treatment for chronic PTSD in a consistent, timely and highly-accessible manner,” Westfall continued. “Because it is a focused program, it can also provide better outreach to veterans with chronic PTSD.” – by Savannah Demko

Reference:

Westfall NC, at al. #P2-101. Presented at: American Psychiatric Association Annual Meeting; May 5-9, 20178; New York.

Disclosures: Westfall reports no relevant financial disclosures.