Using Evidence-Based Practices to Treat
Veterans With PTSD
continued from page 22 ment , but nearly always the rereading yields a sense of peace and relief that beliefs once firmly held can indeed be challenged . during the CPT treatment they are receiving as part of our clinical trial , and that my goal is for them to become their own therapist . I sometimes joke about the counterintuitive notion that I ’ d like to put myself out of a job because they will be able to do it on their own , and I receive a gracious chuckle most of the time .
Phase IV — Learning to challenge : During this phase , individuals reflect on common patterns of problematic thinking and begin to challenge their stuck points using the Challenging Beliefs Worksheets , or CBW . I often remind my participants that these patterns can be quite common , and that anyone can have beliefs that fall within these patterns . These sessions occur before the counselor or clinician reviews the trauma themes modules .
Phase V — Trauma themes : Next , we review common themes related to trauma , including safety , trust , power and control , esteem , and intimacy . It is likely that someone ’ s stuck point will fit more than one related theme . For example , the stuck point , “ I must be in control at all times ,” may be related to themes of safety as well as power and control .
Phase VI — Facing the future : Finally , we talk about the future . When discussing our goal for them to learn strategies during the treatment that they can use after our work together ends , I may ask , “ What stuck points will you work on after concluding our treatment together ?” Participants often have stuck points remaining on their Stuck Point Log , which doesn ’ t reflect their treatment success . We discuss how this CPT treatment can jump-start their ability to maintain progress .
The final , termination session is bittersweet , as many termination sessions can be . We have spent more than 10 hours together over the past two weeks . I have asked these veterans about arguably the worst moments of their lives while I am still a stranger , a new person to them . During the final session , I ask clients to rewrite their impact statement .
Many times , the second impact statement looks starkly different from the first , with appropriately accommodated stuck points that provide a more balanced perspective of their most traumatic event . Sometimes , tears appear when they reread the first impact state-
CAUTIONS
Resources for Treating Veterans With PTSD
• Suicide and Trauma Reduction Initiative Strive2Be . org
• CPT for PTSD cptforptsd . com
• Center for Deployment Psychology deploymentpsych . org
• Clinical Readiness Project clinicalreadinessproject . org
• CPTWeb , the asynchronous training course through the Medical University of South Carolina : cpt2 . musc . edu
• APA Division 12 : Clinical Psychology div12 . org / psychological-treatments
• STRONG STAR ( Consortium : patriot . uthscsa . edu / strongstar ) ( Training Institute : strongstar . org / training )
• National Center for PTSD www . ptsd . va . gov
Just like any other treatment or provider , CPT may not be a good fit for every client with PTSD or a history of trauma . In my advanced assessment course with second-year students in our clinical mental health counseling track , we discuss the four factors in choosing an EBP . All of these factors must align for a treatment to be successful :
• The context or setting in which you practice ,
• The research evidence of the treatment ,
• The experience and training of the counselor , and
• The values and experiences of the client .
Implementing evidence-based treatment in community agencies or schools requires an intense investment in training , money , and other resources . Some EBPs may require consultation and fidelity monitoring , which can be time-consuming and again , quite costly . CMHCs may encounter barriers to accessibility of evidence-based practices . Trainings for certain EBPs may be sparse , hard to find , and frequently quite costly ; however , many organizations make trainings available to clinicians , ( see the list in the box below ).
FLIPPING THE SWITCH
CPT is the closest thing I have found to a lightbulb switch . The idea that we CMHCs may offer our clients a treatment that leads to relief from symptoms of PTSD invigorates me to speak of the benefits of using time-bound , manualized treatments with clients .
About two weeks after completing “ Gary ’ s ” treatment , a package awaited me when I arrived at the office . I knew immediately who had sent it when I opened it and discovered , neatly and carefully secured within layers of newspaper and packing peanuts , a hand-crafted bowl with a laserengraved pattern . My heart swelled when I read the handwritten note that accompanied the gift , which said simply , “ Thank you for taking the time to actually listen to me .”
The Advocate Magazine 2022 , Issue # 3 American Mental Health Counselors Association ( AMHCA ) www . amhca . org 23