Effectiveness of Treatment of Veterans with PTSD: a Critical Review
Journal Title: Journal of Experiential Psychotherapy - Year 2019, Vol 22, Issue 2
Abstract
Introduction: PTSD impacts physiological, neurological, biochemical and epigenetic systems and is experienced largely unconsciously. Measures of treatment effectiveness vary widely but correspond to whether the modality of treatment creates an experience that is dominantly conscious or non-conscious. Objectives: We evaluate the effectiveness of treatments for PTSD in the veteran population based on an analysis of published research. Methods: A literature scan for PTSD, veterans and military personnel was conducted using CINAHL, PubMed, PILOT, Embase, ResearchGate, ScienceDirect, Wiley, PsycINFO, SpringerLink, ProQuest, PsycNET, MEDLINE, VA.com and Cochrane Library. Results: 1. Pathology is widely described but not related to diagnosis, treatment or measures of treatment efficacy. There are no descriptions of pathogenesis and nothing explicit about causation for veteran populations. 2. Measures of treatment effectiveness are varied and inconsistent. Conscious therapeutic treatments like rational or cognitive behavioral therapy experience low efficacy, refractory response is 30-50%, and non-response is high. 3. Soldiers and veterans diagnosed with PTSD benefit less from psychotherapy than non-military populations. 78% of veterans are still in treatment after four years. 4. The research and treatment field is siloed by specialty and lacks a collaborative approach. Treatment of PTSD is hampered because veterans are reluctant to seek help. Also, PTSD is a multisystem response that is idiosyncratic and manifests in many ways. Conclusions: 1. Treatment of PTSD could be more effective if it moved away from a symptom focused diagnostic process toward an ecology-based, systems approach that focuses on wellness. Collaboration across fields is therefore needed, along with effective comparison between studies against common criteria. 2. Approaches that are unconscious such as Eye Movement Desensitization Reprocessing, Trauma informed Coaching, Virtual Reality and Reconsolidation of Traumatic Memory are highly efficacious but more sparsely studied when compared with Cognitive Behavioral Therapy and Exposure Therapy. 3. Treatments need to consider efficacy, balanced against refractory responses and risks of exacerbating the condition or harming the patient.
Authors and Affiliations
Robert Holmes, Ian Snape
Keywords
Related Articles
- EP ID EP639082
- DOI -
- Views 56
- Downloads 0
Bringing the Body in the Educational Environment: a Theoretical Approach
Introduction: We initially experience the world through movement and only afterwards we develop the verbal language, which makes human beings pre-linguistic. Movement is the fundament of all learning processes, therefore...
Evaluating Different Dimensions of Gay and Lesbian Identities: a Comparative Study
Introduction: This study is based on the fact that developing a positive gay or lesbian identity is a multidimensional process comprised of both individual and social mechanisms that facilitate self-acceptance and assimi...
Journal of Experiential Psychotherapy, vol. 16, no 2 (62), June 2013
Vol. 16, no 2 (62), June 2013: see more at http://jep.ro/en/2013
Differentiated Personality Structuring in Institutionalized and Non-Institutionalized Teenagers – A Study of Two Groups from Bucharest –
Introduction: The authors tried to understand whether there is a significant difference between the institutionalized and non-institutionalized teenagers, in terms of self-esteem; whether the institutionalized ones have...
Using Experiential Metaphors in Assessing Self-Image in Children with Attention Deficit Hyperactivity Disorder
Introduction: The paper presents the construction and validation of a process research instrument in experiential psychotherapy, aimed for the detection of improvements in the self-image of children diagnosed with ADHD....