PTSD Therapy for Veterans and How does PTSD Therapy Work?
“Intensive cognitive therapy for PTSD gets patients better faster…”
“Cognitive behavioral therapy (CBT) is one type of counseling. Research shows it is the most effective type of counseling for PTSD. The VA is providing two forms of cognitive behavioral therapy to Veterans with PTSD: Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy”
“Prolonged exposure therapy, a cognitive-behavioral therapy involving exposure to memories and reminders of past trauma, has long been regarded as a gold standard treatment for PTSD…”
“There is a similar kind of therapy called Eye Movement Desensitization and Reprocessing (EMDR) that is used for PTSD. Also, medications have been shown to be effective. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.”
As a Licensed Social Worker that works with active duty, vets and their families, I’m on a LOT of email lists. It pays to stay on top of all the “latest and greatest” information and trends because there’s lots of stuff going on out there with regards to treatments and PTSD therapy techniques. Some of it works well, some not so well, some not at all. There’s also some treatment methods that are met with huge amounts of skepticism by “the establishment”. The term usually applied to these methods are “Non-Traditional”, which is a really nice way of saying “these methods are really weird to us, and we’re uncomfortable with them because they either don’t adhere to OUR idea of ‘legitimate’, or there’s not enough data to prove they are effective”. I feel very confident in saying that those of us who deal with PTSD- either as a trauma survivor or as a caregiver, have done massive amounts of reading and research to figure out what’s going on. And I would venture a guess that we’ve also been told bv a mental healthcare professional in one setting or another that “[insert treatment modality name here] is the ‘gold standard’ in the treatment of PTSD”. So it’s always a ‘contest’ in a way- PTSD CBT vs EMDR, etc.
Well, enough of my rambling, I won’t keep you on pins and needles any longer… here’s the secret I talked about. Just between you and me… *looks over left and right shoulder*…. The type of treatment received doesn’t really matter. The single biggest factor that influences a clients’ success in therapy is the “Therapeutic Relationship”, which is the relationship between the counselor and the client. Do you trust your counselor? Is there a solid level of rapport and comfort between you? Do you feel like the counselor actually cares about you & your concerns and challenges? Do you feel like the counselor wants you to get better? Percentage-wise, this accounts for 30% of the “positive outcome expectancy” (meaning success rate of the counseling) figures. Here’s another secret for you… The next biggest factor in the “positive outcome expectancy” is…. wait for it…. “Client Positive Expectancy”, ie; HOPE. Hope- as in you feeling like you can make it through your issues and come out on the other side. The definition of ‘Hope’ is- “the feeling that what is wanted can be had or that events will turn out for the best” How or why can feel this way, you ask? Well, take a look at secret #1. If you have a counselor that you bond with, that makes you feel comfortable and like you’re a person that matters, and not just a number you’ll feel like “Wow. After all this time, someone really gives a shit about what I’m going through!” Without a feeling of hope, we’re stuck in that long and dark tunnel & feeling like there’s no light at the end. So… taking those two secrets alone into account, that’s 45%. If you add in a couple of other figures that are heavily influenced by secret #1 and #2, (completion of treatment, for example) that accounts for a whopping seventy-five percent (75%) of “Positive Outcome Expectancy” = YOUR success. When it’s all said and done, only 25% is directly related to the method of treatment and techniques used to apply that treatment.
On my personal journey, EMDR worked very well for me- but as I stated, it’s different for everyone. I know people that EMDR didn’t work for at all. However, looking back on my therapy I have to say that the biggest thing that helped was my Therapist. When I went in there, he made me feel like he cared about my success. I felt like I was heard, and that what I said mattered to him. When I started to hit a wall and was hesitant to follow through on something, he read me like a book and said “Look, Don- I’m here to help you and you’ll always get my best effort. But if YOU aren’t willing to do the same, we may as well stop what we’re doing right now. So do you want to feel better, or do you want to go home?!”. Blunt? Yup, absolutely- but he knew me, and knew that was what would work for me and that it was what I needed to hear. And how did he know that? He knew because he CARED, he listened to me, and was invested in me as a person and as a client. And that’s my point. As clients, as people who are struggling and want to be in control of our paths in life that connection is so important. Of course everyone is different, but in my experience as a professional working in the community with trauma survivors almost universally feel like “no one understands”, “no one gives a shit” or “they don’t want to hear the truth about ‘over there’ or ‘what happened’ ”.
This entry was just to enlighten everyone about “the real deal” as far as treatments available and to answer that question “What is PTSD therapy like?”. I know that too many times I hear folks say “When I went to [insert organization or government agency here], I felt like a number. They just threw pills at me, shuffled me off to group therapy and didn’t even listen to what I wanted to say” or similar statements. And trust me- that’s a tame one… I’ve even had people tell me that they were told by a “therapist” that they needed to “Man up” and that they were “Failing as a leader” or “A failure as a husband and parent”. I've even had people tell me that their 'therapist' said- "Well, you can't be doing too bad. Your uniform is squared away, your nails are done, your hair looks good" No… REALLY… I’ve had people share that with me.
My advice, for whatever it’s worth is simply this- if you don’t feel like you’re “being heard”, or that you don’t feel comfortable with a counselor no matter WHERE you seek help don’t just “suck it up”. Say something, or ask someone to advocate for you and have them say something. You absolutely, under NO circumstances whatsoever, deserve to be treated like crap, like you’re just a number, or like you’re just a client who doesn’t know any better. You and you loved ones deserve to be treated with care, respect, dignity and worth. And as I’ve said multiple times on my website and elsewhere- Warrior Elder Counseling Services, LLC is going to deliver on that promise of caring, listening, and non-judgement.
P.S.- You don’t have to take my word for all of the above. Here’s a link to the research I cited-
https://www.researchgate.net/publication/305680127_The_relative_efficacy_of_bona_fide_psychotherapies_for_post-traumatic_stress_disorder_A_meta-analytical_evaluation_of_randomized_controlled_trials
The title of the article is- “The relative efficacy of bona fide psychotherapies for treating
post-traumatic stress disorder: A meta-analysis of direct comparisons” by Steven G. Benish, Zac E. Imel, Bruce E. Wampold. The main points in the “Abstract” were this- “…The primary analysis revealed that effect sizes were homogenously distributed around zero for measures of PTSD symptomology, and for all measures of psychological functioning, indicating that there were no differences between psychotherapies.” and “…The results suggest that despite strong evidence of psychotherapy efficaciousness vis-à-vis no treatment or common factor controls, bona fide psychotherapies produce equivalent benefits for patients with PTSD.”
