Army News 23 Feb 17

PTSD and prolonged exposure therapy

PTSD is a complex and challenging disorder to treat, but effective treatments are available and a key to success is asking for help early. 

Commander Joint Health and Surgeon General of the ADF AVM Tracy Smart said the ADF provided comprehensive mental health services for its men and women, but not everyone responded well to traditional therapies. "When mental health problems are left longer they are harder to treat," she said. 

"If you need help, whether serving or ex-serving, tell someone and get the help you need as early as possible. "Someone may be diagnosed with PTSD, but with treatment it may not become a chronic debilitating illness. 

"The value of the RESTORE trial is it will help us to understand if prolonged exposure therapy can be delivered effectively over a shorter timeframe. "To understand this we need to see if there is a different effect for those who receive the therapy once a week over 12 weeks and those who receive it every day for 10 days. If the more intensive version is as effective, then this could mean in the future that receiving treatment for PTSD is less disruptive on someone working within a unit." 

AVM Smart said the RESTORE program was a longterm initiative and investment that would hopefully remove some of the barriers stopping people seeking treatment for PTSD. "Mental health still has an underlying stigma attached to it -it's often treated as a sign of weakness," she said. 

"There is also a myth that as soon as you have a mental health problem, tick a box on your Return to Australia Psychological Screening form, or put your hand up, your career is over. 

"There are a lot of people who have been diagnosed with and treated for PTSD who are now back in their normal roles or being deployed overseas." Studies and trials in the US have shown prolonged exposure therapy significantly reduces the symptoms of PTSD, depression, anger and anxiety in trauma survivors. 

Practitioners in many countries use prolonged exposure therapy to successfully treat survivors of varied traumas, including rape, assault, child abuse, combat, vehicle accidents and disasters. Director General Mental Health, Psychology and Rehabilitation at Joint Health Command, David Morton, said the RESTORE trial was an important opportunity to look at how prolonged exposure therapy could be provided in the military setting. 

"While working with a mental health professional trained in this therapy, they are given the confidence and opportunity to explore and talk about their traumatic experience in a safe environment," he said. 

"The idea is to reduce the level of fear they have when they remember those experiences and incorporate this into how they can get on with their life." In addition to reducing symptoms of PTSD, prolonged exposure therapy instils confidence and a sense of mastery, improves various aspects of daily functioning, increases people's ability to cope with courage rather than fearfulness when facing stress, and improves their ability to differentiate between safe and unsafe situations. 

Mr Morton said the RESTORE program covered current and former ADF members because the treatment was the same for both groups. 

"We still don't want people to wait until they leave Defence to seek treatment and we are encouraging them to get help as early as possible so they can continue their career as a soldier, sailor or airman," he said. 

"If someone thinks they may be suffering from PTSD we want them to raise their hand and visit their medical officer or other health provider at their local Garrison Health Centre. 

"We will then discuss the RESTORE trial and where they may be able to access treatment while at the same time looking at ways they can remain in the workforce and return to their job as quickly as possible."