Wounded Warriors with PTSD.....

[Military Psych]

Posting this to let community members know about a FREE resource for Veterans and military mental health professionals who treat them. OIF/OEF Veterans or providers can download a 200 page Cognitive Behavioral Therapy manual for Combat related PTSD. The manual is in use at several military treatment sites and can be downloaded at www.war-related-ptsd.com.


The treatment manual covers several evidence based treatments, such as Cognitive therapy, Exposure therapy, and various relaxation techniques. Cognitive therapy and Exposure therapy were designated by a DoD/Veterans Affairs panel as being the most effective for PTSD.

The manual can be used to learn about PTSD and was designed to be used with a provider who can guide Veterans through the exercises proven to help reduce or eliminate PTSD.


The manual has several additional Modules, each addressing an aspect of War-related PTSD that our Veterans face, such as:

Appendix A: Additional Modules
Module 1: Relaxation Techniques
Module 2: Improving Sleep
Module 3: Managing Anger
Module 4: Managing Dissociation & Re-experiencing Symptoms
Module 5: Managing Guilt
Module 6: Alcohol and PTSD
Module 7: Medications for PTSD
Module 8: Other Types of Treatment
​

I hope this information is helpful. If you are a Psychiatrist / Psychologist or LCSW treating Service members or Veterans please visit the site and look over the manual.

If you know a Veteran struggling with PTSD please share the link to the free treatment manual: www.war-related-ptsd.com.

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[Gastrapathy]

Dr Cook,

Skimmed your website. It appears well put-together. However, you have a 200+ page document in which you define and explain a variety of aspects of PTSD and there is not a single reference to be found. I bet you put this together over time as you treated patients and that you are sufficiently comfortable with the topic that you didn't have to look much up to write this, but that doesn't make them your ideas. Now that you've published it, there is a higher standard. This wouldn't fly for a book chapter and it really shouldn't fly for any reference for medical professionals or laypeople. Reference your sources. Intentional or otherwise, this is plagiarism in its current form.

Oh yeah, run a spellcheck.
-G

 

[Military Psych]

G -

I appreciate the constructive feedback and the concern. I do, however, want to point out that it is relatively common for mental health treatment manuals designed specifically for patient use to provide few or no textual citations/references. See for example The Anxiety & Phobia Workbook by Edmund J. Bourne and Edna Foa's Reclaiming Your Life From a Traumatic Event, both of which are frequently used in clinical psychology and sometimes applied specifically to military populations as well. Textual citations and references are much more common in accompanying provider manuals (if available - not all patient workbooks have associated provider manuals). I hope to make a provider manual to accompany the downloadable patient manual available in the near future.


V/R,
JC

 

[DogFaceMedic]

Is this for provider use or pt use? Message one sounds like it is for provider, and your next message is that the manual is for pt use and does not need notes.

If it is evidence based, then sources are absolutely mandatory. PTSD is highly controversial and evidence for your approach is very much needed.

I am very hostile to the practice of drugging up soldiers w/ SSRI's, atypicals, and even TCA's again, and then hope they don't make good on their SI.

CBT has a good role, but for many soldiers it is counter-productive. It is not a silver bullet.

You need references.

 

[VHADOC]

Good initiative, but that's about it. Do you think that you live in vacuum?

On drugs: I quote the following from the download:
"Indeed, medications that help normalize chemicals in the brain can help manage PTSD symptoms. But, the imbalance theory does not explain why so many people continue to have anxiety even when they are taking medications."

Nonsense with a capital BS! There is zero evidence that brain chemical "imbalance" is responsible for PTSD, as well as a similar level of evidence demonstrating that medications restore some of the aforementioned "imbalance." Ascribing "imbalance" as the cause of malady generally speaking fell out of favor >100 years ago. Bone up on your neuropharmacology.

To be sure, PTSD is under-treated. At the same time, over-treatment (specifically over-diagnosis) seems to be nearly or as harmful as the condition itself. Have you been to any PTSD group therapy meetings?

I deal with hardened PTSD on a daily basis and can not fathom to whom this poorly written document is targeted towards. PTSD, insofar as I understand, is a process that occurs secondary to nature/nurture issues prior to, during, and after an event, all of which cannot be treated with a cookbook approach.

It is only because of financial and time constraints that we treat it so poorly, as such, further endeavors to create better cookbooks should be discouraged.

Before re-inventing the treatment of PTSD you may want to:
1) define the average reliastic PTSD sufferer
2) use care in avoiding over-diagnosis
3) emphasize need for further clinician interaction
4) understand the time and financial constraints of clinicians

The greatest impedance to better treatment is lack of time/money. Home based CBT is an alluring idea. At the same time, to suggest that self-guided CBT should be used as a first-line treatment is bogus at best, lethal at worst, and patently folly. People suspected as suffering from PTSD need early evaluation by a clinician.