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Effects of Integrative PTSD Treatment in a Military Health Setting


Citation: Libretto, S., Hilton, L., Gordon, S., Zhang, W., Wesch, J., Effects of Integrative PTSD Treatment in a Military Health Setting. Energy Psychology Journal. November 2015.

Abstract

Research indicates that the current standard of care for combat-related stress disorders and related conditions is not maximally effective, nor does it fully address the biopsychological aspects, complexity, and overlap of precursors and co-morbidities characteristic of posttraumatic stress disorder (PTSD). There is need for comprehensive interventions based upon both neuroscientific information and new integrative care models. The Warrior Combat Stress Reset Program (Reset), an innovative intensive outpatient behavioral health program at the Carl R. Darnall Army Medical Center at Fort Hood, Texas, provided integrative care for active-duty service members for the treatment of PTSD symptoms from 2008 to 2015. The Reset protocol combined trauma-focused behavioral health techniques with complementary and alternative medicine (CAM) modalities including acupuncture, mas- sage, Reiki, reflexology, and yoga. A retrospective, observational, quasi-experimental design was employed to determine the change in health outcomes from pre- to post-treatment. Treatment outcomes were analyzed for 764 service members who attended the 3-week behavioral health program between 2008 and 2013. Results indicate significant reductions in PTSD symptoms (PTSD Checklist–Military version; p < .001), anxiety (Beck Anxiety Inventory; p < .001), depression (Beck Depression Inventory II; p < .001), and pain (Oswestry Pain Index; p < .001) from pre- to post-treatment. Outcome analysis by year indicates steady improvements in treatment gains for these major outcomes over time. Advancement is occurring in the search for effective, evidence-based treatments for PTSD. Reset demonstrated promise for reducing symptoms of PTSD, anxiety, and depression through its integrative approach combining traditional and trauma-focused psychological therapy with CAM treatments.

Craig’s Comments

This study was conducted by a team of researchers, including a clinical psychologist, research methodologist and a health psychologist working at the Warrior Combat Stress Reset Program where the integrative treatment of military personnel took place. The researchers note that military personnel are among the most at-risk populations for PTSD, and that the conventional treatment approach uses pharmacological interventions (meds) along with cognitive behavioral therapy and other psychological approaches. This study sought to measure the effects of additional treatments using complementary and alternative medicines.

The Reset Program was a three-week day treatment program for soldiers still on active duty, in which they participated in a series of different behavioral health activities thought to improve symptoms of PTSD. These included complementary and alternative medicine (CAM) such as acupuncture, Reiki, reflexology, yoga and EFT. During the the 3 week intensive period soldiers would engage in about 36 group sessions, 12 individual therapy sessions, and up to 36 CAM sessions designed for their specific issues. A followup second phase included weekly group, CAM and individual therapy sessions for a 6-8 weeks.

The research component started in 2012 when the project received a grant for comprehensive program evaluation, and the study continued through 2014. It analyzed 764 patient files representing patients who went through program beginning in 2008. Each file included 21 different testing instruments that had been administered at intake and pre- and post-program. These included the PTSD Checklist-Military version, the Beck Anxiety Inventory and many others.  The study tested both the efficacy of the Reset program for treating PTSD related symptoms, and also the effects of the CAM therapies in particular.

So, what were the results? Overall, the researchers found that PTSD, depression, anxiety, pain and resilience showed significant improvement after treatment. The degree of improvement also increased significantly for patients who went through the program in the later years. Researchers attribute this to the fact that the CAM modalities were introduced and expanded upon in these later years as the program developed. This indicates that the different modes of complementary and alternative medicine contributed to a greater decrease in PTSD and other symptoms. These results definitely suggest that CAM treatments may have be extremely beneficial as an adjunct to traditional treatments of PTSD, anxiety, depression, pain and other common symptoms suffered by military personnel.

What about EFT specifically? Although this was only one of many CAM modalities that the soldiers were taught or treated with, the researchers have realized that they want to go back and examine the EFT results. It appears that it was more effective for those soldiers who received 1:1 sessions with trained practitioners.

Sadly, the Reset Program ended in October of 2015 – after seven years of consistently positive results in treating soldiers. The CAM contract has not been renewed and the clinic no longer functions as an integrative program. This is unfortunate as programs like this, along with the accompanying research, have great potential in improving the mental health of all military personnel and especially soldiers who return home after active combat.

Acknowledgment: I would like to express my gratitude for the invaluable assistance of Sarah Grace Powers in the creation of this post.