The Advocate Magazine 2022 Issue 3 - Page 20

‘ Honoring Truth While Challenging Perspective ’; Using Evidence-Based Practices to Treat Veterans With PTSD

We sat together silently for a few moments , the weight of the recent realization reverberating in the room . I was working with “ Gary ,” a new participant in a clinical trial on treatment for posttraumatic stress disorder ( PTSD ), in which we administer intensive Cognitive Processing Therapy ( CPT ) to military personnel and veterans , in person or via telehealth . This is one of the clinical trials being run at STRIVE , the Suicide and Trauma Reduction Initiative , at The Ohio State University ' s College of Medicine .
C . Rosie Bauder , PhD , MPH , LPCC , is a postdoctoral scholar with the Suicide and Trauma Reduction Initiative ( STRIVE ) at The Ohio State University ’ s College of Medicine and a Licensed Professional Clinical Counselor in the state of Ohio . She received her PhD in Counselor Education from The Ohio State University in 2021 and holds a master ’ s degree in Mental Health Counseling and Behavioral Medicine from Boston University ’ s School of Medicine . Her research involves evaluating the effectiveness of suicide-specific and PTSD treatments , qualitative components of crisis response planning for suicide prevention , and the relationship between firearms and suicide .
Gary was a veteran from Desert Storm , the U . S . campaign against Iraq to liberate Kuwait in 1991 . He had just flown to Columbus to attend our two-week , in-person treatment known colloquially as R & R , or Recovery and Resilience . Now retired , he spent much his time outdoors looking for pieces of wood to bring back to his woodshop , where he would turn them into visually striking bowls and plates with intricate , laser-engraved patterns for friends and family .
We had just reviewed a component of CPT known as the levels of responsibility worksheet . The pivot was tangible , so much so that I imagined a lightbulb above his head , flickering on , and then shining vibrantly . We had reviewed a stuck point ( see box on page 21 ) of his in which he believed that because of what he had done , he deserved to suffer for the rest of his life .
I will not divulge the details of the traumatic event that served as the index for our treatment together ; however , many of the clients with whom I work discuss events that have occurred in the unique and often-fraught context of deployment or combat . “ I feel so guilty , it must have been my fault .” In CPT , we Clinical Mental Health Counselors ( CMHCs ) counter this stuck point by asking , “ In what way are you confusing feelings for facts ?”
Together , we had cultivated a powerful phrase that I have since used with virtually all of my clients ; “ Honoring truth while challenging perspective .” This phrase has become so meaningful to my clients and me that I made it the title of a session I had the privilege of presenting at the American Mental Health Counselors Association ( AMHCA ) conference this past June in Las Vegas . I find that this phrase has resonated with virtually all of my clients since , and I regard it as a succinct way to describe the function of CPT in treating PTSD .
Posttraumatic stress disorder ( PTSD ) is considered one of the “ signature injuries ” of the U . S . military operations in Iraq and Afghanistan and is the most frequently diagnosed mental health condition among veterans of these conflicts . It ’ s estimated to be twice as prevalent among veterans compared to the general population , bit . ly / 2qFEIeL . PTSD is not only prevalent among veterans of these conflicts , it has also disparately impacted veterans of the Vietnam war . In the course of my time working with veterans , I have worked with individuals from all of these conflicts .
Note : Excerpts and names have been altered to preserve clients ’ and participants ’ confidentiality .
PTSD is not just a consequence of combat , however ; many military personnel and veterans experience non-combat related traumas such as sexual assault , domestic violence , intimate partner violence ( see article on page 15 ), or have histories of early-life trauma such as child abuse that can also contribute to PTSD . In the course of my work with servicemembers and veterans , I would estimate
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20 The Advocate Magazine 2022 , Issue # 3 American Mental Health Counselors Association ( AMHCA ) www . amhca . org