To help veterans with combat-related post-traumatic stress disorder (PTSD), some researchers recommend a multi-component treatment for improved efficacy. The key components include exposure therapy, programmed practice, social and emotional rehabilitation.
Exposure Therapy
Exposure therapy places the individual in the situation that creates anxiety and remaining there until the emotional distress elicited by the feared object/event/situation has been extinguished.
It includes reconstructing and narrating the traumatic events in details, with attention to the sights, sounds, and smells that were present when the original event occurred.
In many cases, it is advantageous for the patient to narrate the event because it appears to increase immersion, which in turn increases treatment efficacy.
Programmed Practice
It is not accompanied by a therapist (i.e., it is “homework”). Geared toward the individual’s unique trauma, assignments may involve watching movies (e.g., Black Hawk Down, Restrepo), visiting crowded places, or engaging with others in crowded social settings.
Social and Emotional Rehabilitation
Behavioral activation
Veterans identify areas of everyday life where improvements are desired, and plan daily activities that are consistent with the values identified as important.
The life areas include family relationships, social relationships, employment/career, physical and psychological health issues, responsibilities, romantic relationships, education/training, hobbies/recreation, volunteer work/charities/political activities, and spirituality.
Sleep hygiene
Sleep difficulties are a common complaint by people with PTSD. Therapists will instruct veterans on the concepts and practices of sleep efficiency.
Anger management
Teach veterans how to better manage anger and other intense emotions. Procedures include role playing, work sheet and group discussion.
Management skills include identifying high-risk situations and planning ahead, taking a break during a heated moment, reevaluating the situation, problem solving, and using assertive communication.
Social reintegration
Teach veterans how to establish/reestablish and maintain friendships, skills necessary to engage in and maintain new and diverse social activities or to reestablish strained interpersonal relationships with family, friends, and coworkers.
Relapse prevention
Veterans discuss the situations/events/people that might serve as triggers for a return to behaving inappropriately in formerly problematic situations, as well as alternative responses.
Source consulted:
Beidel, Deborah C., et al. “An intensive outpatient treatment program for combat-related PTSD: Trauma Management Therapy.” Bulletin of the Menninger Clinic, vol. 81, no. 2, 2017, pp. 107-122.
GenPsych PC has a Military Program that offers treatment specifically designed for the unique needs of active duty service members and veterans from all military branches. Learn more at the Military Program page.
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