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Enhancing Social Support May Improve Cognitive Processing Therapy Outcomes in Telemedicine for PTSD
Date posted: 06/10/2020
Topic: Military and Combat
As we work to sustain and tailor our mental health services during the era of COVID-19 and think ahead to future clinical needs, clinicians are increasingly transitioning their care to telehealth modalities. The good news for health care providers is that telehealth-based delivery of gold-standard posttraumatic stress disorder (PTSD) treatments such as Cognitive Processing Therapy (CPT; Resick et al., 2017) has been shown to be no less effective than in-person delivery of care (Morland et al., 2014, 2015). Although CPT delivered remotely appears to be noninferior to in-person care, providers may be curious about which characteristics of individuals seeking to participate in CPT via telehealth might improve their outcomes. Malleable characteristics, such as the amount of social support an individual perceives they have, are of special interest if their enhancement might direct providers to specific treatment plans or targets. Although some research has shown social support can encourage greater reductions in PTSD symptoms (Price et al., 2018), individuals living in rural areas might have important differences that could change how social support benefits treatment. Therefore, we set out to evaluate the degree to which pre-existing perceived social support could enhance the effects of CPT for rural American military veterans participating in a pragmatic randomized effectiveness trial of telehealth-based collaborative care for PTSD (Fortney et al., 2015).
Military Matters: The Mental Health and Service Utilization Among Reserve and National Guard Forces Study: A Summary of Key Findings
StressPoints
Date posted: 05/4/2020
Topic: Military and Combat
The reserve component of the United States military plays an important role in national defense, accounting for approximately 40% of deployed forces in recent conflicts (Tanielian & Jaycox, 2008). Currently, the reserves represent 53% of the total Army population, yet there is relatively little research examining mental health problems among reserve personnel (Vogt, et al., 2008).
Trauma and Diversity: Moral Injury Among Justice-Involved Veterans: An Understudied Clinical Concern
Date posted: 05/4/2020
Topic: Military and Combat
While the concept of moral injury has existed for years, moral injury has received increased empirical attention over the past decade. Many definitions of moral injury exist; however, one of the most commonly used is by Litz and colleagues (2009) who define moral injury as “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.”
Death Notification: Challenges for Health Care Providers and Other Professionals
Date posted: 04/4/2020
Topic: Military and Combat
Although the phrase, death is a part of life, is commonly stated, discussions about death and informing those who are impacted by it remain uncomfortable topics for professionals. Recently, researchers at the Center for the Study of Traumatic Stress created an informational guide titled Notifying Family Members After Unexpected Deaths: Guidelines for Healthcare Providers that is readily available online:
How to Predict and Mitigate Risk of Evacuation of US Service Members from Deployed Settings for Behavioral Health Reasons
Date posted: 04/21/2020
Topic: Military and Combat
Acute behavioral health crises are one of the leading causes of medical evacuation from combat operations for American service members (Williams, Stahlman, & Oh, 2017), and evacuees with psychiatric disorders are less likely to return to duty (Cohen, et al., 2010). We set out to determine variables that may help predict which service members are more likely to be medically evacuated from theater for behavioral health concerns.
Comparison between Women-Only and Mixed-Gender Intensive PTSD Treatment for Female Veterans
Date posted: 08/2/2019
Topic: Military and Combat
Women veterans diagnosed with PTSD are an especially rapidly growing subgroup of VHA patients (Washington, Davis, Der-Martirosian, & Yano, 2013), constituting 10.3% of all those diagnosed with PTSD in 2015. With the recognition that women veterans with PTSD have often experienced different types of trauma and have different needs than men, specialized intensive treatment is also offered in two specialized intensive Women’s Treatment Rehabilitation Programs (Karlin et al., 2010).
Clinical Considerations for Trauma-Related Guilt in Military Personnel
Date posted: 07/1/2019
Topic: Military and Combat
Guilt is commonly reported by trauma survivors and has been linked to greater posttraumatic stress disorder (PTSD) severity (e.g., Bryan et al., 2015). As such, understanding how guilt impacts PTSD recovery has been of significant interest to clinicians and researchers.  Indeed, there has been debate about whether prolonged exposure therapy (PE) is as effective for those with high guilt, with some suggesting that imaginal exposure to trauma memories is either unhelpful (e.g., Grunert, Weis, Smucker, & Christianson, 2007) or potentially iatrogenic (e.g., Pitman et al., 1991).
Military Matters: Moral Injury: A Brief Overview
Date posted: 06/1/2019
Topic: Military and Combat
Unlike single-incident civilian traumatic stress contexts, military combatants are at risk for exposure to a variety of distinct, potentially traumatic harms over a long period of time, all of which occur in a unique occupational, cultural and highly moral context.
Can trauma cause a moral injury?
Date posted: 01/1/2019
Topic: Military and Combat
There has been a growing interest in traumatic events that may violate people’s core moral beliefs. While not exclusively a military-related issue, some service members and veterans attribute chronic and pervasive problems to potentially morally injurious deployment-related experiences such as injuring or killing enemy combatants or failing to prevent the suffering of fellow service members or civilians.
Trauma and World Literature: Moral Injury
Date posted: 01/1/2019
Topic: Military and Combat
The challenges for many soldiers returning from war go beyond the potential for PTSD, moral injury, traumatic bereavement and a range of associated risks from increased rates of suicide to a host of physical illnesses.
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