Three signs of good PTSD care for Veterans


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As a Veteran with PTSD, you deserve the best treatment available. Whether you are seen at VA, in a Vet Center, or by a community provider, you need to feel sure that your care is working for you.

If you are happy with your care, if your symptoms are getting better and you feel hopeful for the future, then you are all set.  But if you don’t feel like you are making progress or you are not satisfied with your care, you might be wondering what to do next.

Once treatment starts, you should stay an active player in your care.

Let these three signs of quality care guide you. You can refer to them if you are in treatment, especially if you are not happy with your progress or before you begin to work with a provider. They don’t all have to be present for you to know the treatment you are getting is high-quality. But they each will improve your chances of getting the care you deserve.

#1: You’re involved in your care

If you have ever been diagnosed with a medical condition, your provider probably told you your treatment options, and you worked together—perhaps with your family—to decide on the care that was right for you. Why should your mental health care be any different?

In the best case, your provider talks with you about the effective treatments that are available for PTSD—both psychotherapy (talk therapy) and medication (drug therapy). The two of you can then discuss what matters most to you, what your goals are, and which treatments match up with your likes and dislikes.

For example, if you are OK with the idea of talking about your trauma with a therapist, trauma-focused talk therapy would be a good fit. If you know that you’ll forget to take medications on a steady basis, drug therapy might not be the best choice for you.

Once treatment starts, you should stay an active player in your care. Depending on the treatment, that could mean doing some work on your own between appointments, or taking your medication as directed.

LEARN MORE:

The PTSD Treatment Decision Aid is a great way to learn about treatments and consider which one is right for you.

Group Therapy

#2: You follow a proven treatment

There are a LOT of treatments available for PTSD, but evidence-based treatment has the best chance of working. Evidence-based treatment—both talk therapy and drug therapy—is treatment that has been proven to work for many people in multiple high-quality research studies.

Among evidence-based treatments, one type stands out: trauma-focused psychotherapy. It is the most effective PTSD treatment.

“Trauma-focused” means that the treatment focuses on the memory of the trauma or its meaning. There are different types of trauma-focused psychotherapy. Some names you might hear are Prolonged Exposure , Cognitive Processing Therapy and EMDR. In trauma-focused psychotherapy, you’ll meet with your provider once or twice a week for about 4 months. Treatment is time-limited.

Medication—drug therapy—also treats PTSD well. The evidence-based medications that have been shown to work best are sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), and venlafaxine (Effexor). If you choose medication to treat PTSD, you’ll need to keep taking it for it to keep working.

There are other treatments available. If you are happy with a treatment we have not listed here, there is no need to change it. Sometimes people may choose a treatment that does not have a strong evidence base, and that treatment may be helpful.

But there is one type of treatment that does not help with PTSD symptoms and can in fact be harmful: benzodiazepines—or “benzos.” Some names you may have heard are alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and temazepam (Restoril). Benzos are sometimes prescribed short-term to treat extreme anxiety, panic, or sleep problems.

In the long-term, though, they can be addictive, cause other mental health problems, and make talk therapy less effective. If you are taking benzos for PTSD, work with your provider about making a plan to stop. There are other treatments that are safer and more effective.

LEARN MORE:

Two people holding hands

#3: Your progress is measured

Without checking your blood pressure or your weight, how would you know if your high blood pressure (hypertension) treatment or diet was working?  It’s the same with PTSD.

With the best PTSD treatment, your provider will monitor how you are doing. One way to do this is to have you fill out a brief questionnaire to measure your progress from time to time. Your provider will review the results with you, and discuss what they mean for your treatment. If you are not seeing the results you want, you and your provider can talk about other treatment options to try.

LEARN MORE:

VA is using measurement-based care to track patients’ progress and make sure treatment is working.

Remember: Quality care for PTSD can take many forms. Seeking out these signs of good care in your PTSD treatment can keep you on the road to feeling better.

June is PTSD Awareness Month, and the National Center for PTSD encourages everyone to raise public awareness of PTSD and effective treatments. We can all help those affected by PTSD.


About the authors: Jessica Hamblen, Ph.D., is the deputy for education, at the VA National Center for PTSD and Cybele Merrick, MA, MS, is the associate director for education, at the VA National Center for PTSD.

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Bradley Holland    

    You are SO RIGHT in that statement!
    We didn’t need “the pain” in the first place. We had to relive it to explain “the pain” to other persons (Psych Doc & Psychologist/ Counsellor). Then, we have to explain “the pain” to another & another each time to continue treatment/s. It’s hard enough the first time/s with what caused “the pain” in the first place! Let alone, explain all of our feelings to friends, family, and other loved ones, or even sometimes employers. There should be some kind of safeguards in place for continuity of care, regardless of VA attrition.
    Prayers for all Brothers & Sisters living with the Brain Hell others cannot comprehend?

  2. David C McCoy    

    I was in Vietnam in 1969 and 1970 worked the As-haw Valley right after entering country. I served with 101 Airborne out of Camp Sally. I have seen my fill of pain and heartache. It took me over 35 years to understand that my anger toward everyone that did not serve during this time was associated with PTSD. I an seeing a Psychiatrist once about every 2 months and a Psychologist once a week and she is good the problem is she is her for a 12 week program and then she is gone. I have been working with her for 9 weeks without any progress,i have had to relive my worst nightmares and the VA expects a positive results in 12 weeks and then they change the the only person that seems to care. I feel the VA is to blame for the problems with dealing with veterans that have PTSD.

  3. Stephen Ferreira    

    In 2013 suffered heart issues, with help from another vet I went forward with 2 claims in Sept 2016. 1 for heart c&p and the 2nd was for PTSD same day 1 hr apart.in less than 90 days I was awarded 90%. 1 yr later i filed for tdiu due to angina issues and was denied. Filed a nod and 14 months later the tdiu was awarded. I collected all my documents myself and gave them to my local vso.my appeal was researched by myself thru multiple sites including the va sites.when I came back to the US in Sept 71 in California airport amid a mass of protestors I went to change into civilian clothes, ripped off my 2 patches 82ndAB & 101stAB and threw my military clothes in a barrel. Up until my c&p appointments did I realize how I suffered from PTSD for 48yrs and ignored all the signs,anger, isolation, alcohol abuse. I now see a professional va shrink regularly and my va PC doctor who is kind & caring.i have not yet been told by any va person that they can not help me or won’t help me. I often feel guilty that other vets are not getting the same treatment. There is hope,help, don’t give up.

  4. Debra E Gray    

    Moderation?????? Explain???? Your moderating my heart????

    1. Gary Hicks    

      We moderate comments for spam, hateful/obscene language and libel.

  5. Debra E Gray    

    Did you receive my post??? No confirmation that I am heard?? Thx

    1. Gary Hicks    

      You may have miss entered the CAPTCHA code.

    2. Anne Ford Rector    

      I love you David. I too, have PTSD, although not from the military I served. But I have been an employee with the VA health Care system, and agree with you an dall the others, that it is a $hit hole and allows military people to die. David, please try to obtain a dog through other channels. A DOG IS EXACTLY WHAT YOU NEED. It will help you and love you, just as you have said. There are many rescue operations that will find a dog for you. I have a PTSD therapy cat. Good Blessings and Mine and God’s LOVE to you David and the pooch of your future.

  6. david bertoldo    

    all i wanted was a dog to love me but was told by one of the big vet dog outfits the don’t give guard dog which isn’t what I asked for 100%ptsd no one to love are love me

  7. Louis Wacker    

    I have been through 6 doctors in 5 years. My psychiatrist is through Skype and meetings only last for about one minute. I talk to a computer to some guy in Okland several hundred miles away.

  8. Walter B DeVoe Jr    

    I would like to see more treatment from the psychiatry dept. They do stay on top of your refills, but rarely changed them. They talk about possibly changing meds, and then you 20 minutes are up.
    Really very supportive for someone who is diagnosed with mental problems.
    The psychologists will practice what they learned in school, TESTING. I don’t believe that I have ever received any results. I changed my address, and moved to another state. I was getting, what I thought was good treatment at the VAMC. Now I go to a CBOC, and I am lucky if I have a Dr., to see. I suppose I could travel 2hrs to the VAMC I’m my new state, but I wouldn’t suggest that for a patient.
    You say that you are willing to see an outside provider, paid by the VA, but no results. Sure glad the US Congress approve that system.
    Bottom line, I have been in the VA system for 37 years, and I can truly say overall, I am disappointed with the VA system.

  9. Stephanie Landrum    

    I was refered to a Psychologist that is part of my VA care team. Term used loosly… She let me talk/cry for 30 minutes. Then told me that I could talk to her only 4 more times, 30 minute sessions. Then she gave me a sheet of paper where she highlighted a Women’s Veteran Support Group that meets once a week at only 1PM to 2PM on Thursdays. Because I HAVE to segregate myself as a female? My issue has nothing to do with being a woman. Then I was billed by the VA for that 30 minute session in which she diagnosed me with “Caregiver anxiety and depression”. I served as a medic. Was involved with body recovery of civilians.

  10. Patricia Farnsworth    

    The Mental Health department in Phoenix is a pathetic joke. My son is dead now. How many more are you going to let slip through the cracks? He begged to go to that rehab place in Prescott but was told it had limited space and the wait list was long. It’s to late now. He’s dead. You people misfiled his brain MRI that showed the TBI. But because you have incompetent people working for you, the constant merry-go-round of Dr’s never saw it. It’s to late now. He’s dead. I am his Mom. I can never tell my son I love him and can never hug him again. His blood is on your head VA!
    8 months later you still haven’t sent the pathetic $300 for his death benefit.

    1. Donny    

      Patricia I am so sorry for your terrible loss. I am a Vietnam Vet and feel for you deeply. Your son hugs you every morning from above, and is at peace now. I’m sorry for you both.
      I found the best way to get results is to go directly to the VA office, with a friend, and speak to a VA representative. If not available then, make an appointment for a later time. They will explain all your benefits and help you to resolve your problems. Best of thoughts to you.

    2. Paul    

      Very sad to hear that…Your good son is in Heaven. …No more suffering. .Till we all meet again..
      And don’t get me started with the corrupt VA… We are just a social security number to them, nothing else. I suffer severe post-traumatic stress disorder having been a US Marine Infantryman combat veteran from Desert Storm Somalia and Iraq and Monrovia Liberia during its worst of times. And the help from the VA is very dismal..
      God bless your son ma’am.
      SEMPER Fi. .

  11. Joan Welke    

    is this tri care for life?

  12. Allen Butler    

    Put in a request for a new sych.doctor, couldn’t understand what she was saying Ucraine or some accent that was uncomprehensable ,new shrink is a “golden boy”, only works at the VA 4 times a month, not sure if he can wipe his own nose but he did let me know he has never been in the military, imagine that, what the hell can you tell me about PTSD ?

  13. Craig Womer    

    Is this a joke I was in from 71 to 83 I had 4 TBI’s in a 2 yr span. Think I might have Ptsd, just a little. Migraine come and go regularly. I’ve been married 6 times. Life is just rough. Problems adapting to the norm. VA has tried to kill me 3 times now. After 30 some years I still fight this system. Educate yourself cause they don’t treat do-do. Nor do they know how to clean it up. Treatment yea right like anyone at the VA in Atlanta gives a crap. Craig Womer Disgruntled Vet

  14. jim brandmeir    

    so what is the VA going to replace the benzos and opiads?

  15. pRKs    

    The biggest problem in VA Psychiatry, is that you do not allow Veterans to keep the same psychologists even when they are available.

    I have chosen not to come back in for counseling several times in the last six years when I needed it, because I could never see a psychologist who already knew me and my history.

    Every single time I begin with a brand new psychologist I am required to tell my entire life story from beginning to end. There doesn’t seem to be a single decision maker that understands the amount of pain in this act. Each time I have been forced to do so, I am drawn down into a personal hell people without PTSD cannot imagine. Seeking help means I am already in a Depression/PTSD episode, that’s the danger; I become suicidal or at least have ideations. For years I used self injury to cope with suicidal ideation, I cannot now. My cuts became too large/deep and needed surgical closure.

    Let us keep our psychologist through out our VA history. Or at least those of us who have had/are likely to have a life history. The VA should have permanent positions for psychologists.

  16. leslie cooley    

    Because psychiatrists are trained medical doctors, they can prescribe medications, and they spend much of their time with patients on medication management as a course of treatment. Psychologists focus extensively on psychotherapy and treating emotional and mental suffering in patients with behavioral intervention.

  17. Ronald Lee Embry    

    While PCTS Post Combat Trauma Stress for most Veterans more appropriate know PTSD LABEL what VA PSYCHOS USE. Only thing when my repression stance became dissociative in nature and had the whole merry-go -round treatment it devolved into as Mr Dykes said Rx central. Klonopin main one and Tegetrol+ others. Had to break that as Psychos never in harm’s way just textbooked phony babble.
    Talk?, better try VA Vet Center

  18. wilmer dean day    

    You got to be (redacted) kidding me.

  19. Robert Scott    

    Why am I getting this email with this particular subject to include the lead paragraph? It appears that you may be releasing medical information (true or not) without Hippa authorization.

  20. Donna therese Stearns    

    Yep I had a similar problem…..I needed real hands on psychotherapy and medication. Not just checking the block with a psych doctor every few months…. My situation has changed I start my therapy this month with a New psych and new meds at a new facility. So I have to take a very active approach stay on my care to get the proper treatment that I thought would be given to me when I presented for my PTSD…years ago.

  21. Michael Dykes    

    YeaH, I gotta get on top of my mental healthcare, I have a VA psych, but when I see him we just go through the motions and he renews my pills.

    1. Terry Glen Davis    

      I am going to try to do what a friend of mine did . He got off all the medicine him self . Now I believe some times I think that if I try that , it will work for me .

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