For two decades, a single event defined the life of James S., a 50-year-old veteran from a U.S. suburb: the accidental civilian deaths he witnessed in combat while serving in Vietnam.
“In hindsight, he was looking back and saying ‘I should have done more to save their lives,’” says Dr. Kristin Lester of the National Center for POST-TRAUMATIC STRESS DISORDER (PTSD) at the Veterans Affairs (VA) Boston Healthcare System.
Like so many veterans returning today from Iraq and Afghanistan, James had recurring flashbacks, harbored guilt, and turned to alcohol. He isolated himself from everyone he knew, even his FAMILY. “He struggled with SUBSTANCE ABUSE,” says Lester.
Finally, after decades of suffering, he pushed his way though substance abuse treatment. Only then did he learn about a 12-session treatment called Cognitive Processing Therapy (CPT), originally developed in the 1990s by Dr. Patricia Resick, director of the Women’s Health Science Division of the National Center for PTSD, to treat PTSD in sexual assault victims. Resick and colleagues Dr. Candice Monson and Kathleen Chad adapted CPT to treat soldiers and veterans for traumatic combat-related memories that can lead to PTSD, depression, substance abuse, and even SUICIDE.
James met with Lester and for the first time spoke about his recurring memory of the war zone. He wrote down his thoughts and feelings about his trauma as part of CPT’s required take-home assignments. By the time he completed CPT, his intense emotions about his traumatic memories had begun to fade, and he made efforts to reconnect with his son.
“He identified stuck points, or dysfunctional thoughts, and worked toward changing them to be a more accurate reflection of reality,” recalls Lester. “This allowed him to have a more natural resolution of the traumatic event.”
Several years ago, new studies showed that nearly 20 percent of military service members suffer from either PTSD or major depression. The Department of Veterans Affairs responded by mandating that vets have access to evidence-based treatments such as Cognitive Processing Therapy (CPT). EDC packaged and refined materials for the VA’s CPT workshops for therapists, developed an online enrichment program, and assisted Mile End Films in producing CPT video clips and a CPT educational video.
“There was both a tremendous need and an effective solution to the problem of PTSD among veterans. EDC provided the missing piece by helping the VA to scale up their materials on it, quickly,” says EDC’s Rebecca Stoeckle.
According to the VA, more than 40 percent of returning vets face a mental health diagnosis, revealing a new need: support for their families. To help reunite returning soldiers and their families are two guides, Returning from the War Zone: A Guide for Military Personnel, and Returning from the War Zone: A Guide for Families of Military Members, created by the VA’s National Center for PTSD in collaboration with EDC.
“The guides offer practical, frontline help for service members and families to work through some problems they might encounter when service members return home,” says EDC’s Mary Kay Landon.
Substance abuse continues to be a problem for many returning veterans. The federal government’s substance abuse prevention wing had its five regional Centers for the Application for Prevention Technology (CAPT), including EDC’s Northeast CAPT, develop modules and train instructors to educate the Medical Reserve Corps about reducing drug and alcohol abuse rates in July 2009 in Atlanta, Georgia.
“This was one of the first times anyone in the Air Force looked at ways to educate military personnel and their families on base about alcohol or drug abuse prevention from a public health perspective,” says EDC’s Tania Garcia.
Many vets dealing with PTSD and other mental disorders face the frightening reality of suicidal thoughts. In 2006, EDC’s Suicide Prevention Resource Center (SPRC) trained 1,300 clinicians at 45 Air Force bases around the world about assessing and managing the risk of suicide, which was followed by similar trainings over the next few years for the Marine Corps. Then, in January of this year, a training for all military branches was held.
“We teach clinicians to ask directly about a patient’s suicidal thoughts,” explains EDC’s Xan Young. “That allows individuals to talk about them and eventually move on.”
Originally published on April 14, 2010