Psychotherapeutic Treatment of Post-Traumatic Disorder in Rural Veterans
Abstract
Post-traumatic stress disorder (PTSD) is a significant health issue among the veteran population. PTSD can lead to adverse outcomes such as suicide, violence, substance abuse, and an overall decreased quality of life. Psychotherapy has demonstrated effectiveness in treating PTSD. However, providers may not be aware which specific types of psychotherapy have achieved the strongest levels of evidence . Additional challenges exist in treating rural veterans because of barriers such as geographical distance and a shortage of mental health providers. These obstacles may place rural veterans at higher risk. The purpose of this project was to explore the current evidence that supports the use of psychotherapy in the treatment of PTSD and discuss how these strategies might be implemented for veterans in a rural setting. Shapiro's Adaptive Information Processing Model served as a theoretical framework for this project .
The methods used to conduct this project consisted of first performing a literature review of pertinent articles and current practice guidelines. Expert clinicians within the community were consulted to gain further insight and directly observe some clinical applications of these therapies. Collaborative efforts were made with contacts from the Department of Defense Centers of Excellence and an upper-Midwest rural health agency . A variety of web-based training modules related to the practice of psychotherapy for veterans with PTSD were also reviewed
The findings of this project revealed that cognitive behavioral-based therapies, such as Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy as well as eye movement desensitization and reprocessing (EMDR) demonstrate the greatest level of efficacy in treating PTSD. Technological advances such as telemental health services or virtual reality-based interventions may improve accessibility to rural veterans . Integrating PTSD treatment options into primary care settings, such as community-based clinics may also improve barriers to seeking treatment.
These results have been disseminated to local providers via informational pamphlets and poster presentations. Several accessible, online training websites have also been included as resources that can assist providers in gaining increased knowledge and understanding specific to the psychotherapies discussed as well as issues pertinent to military culture and programs. By increasing providers' awareness of these evidencebased practices, it is hopeful that better care can be offered to rural veterans in treating their symptoms of PTSD and improving overall quality of life . vn