As PTSD cases surge, Army overhauling mental health services

After years of war in Iraq and Afghanistan, the Army is overhauling its mental health services. As after years of war in Iraq and Afghanistan, aiming to end an era of experimentation in which nearly 200 programs were tried on different bases. At Joint Base Lewis-McChord (JBLM) and elsewhere, the Army has pushed counseling teams out of hospitals to embed with troops. It’s also cutting back the use of private psychiatric hospitals while expanding intensive mental health programs at military facilities like Madigan Army Medical Center. The reforms come at a time when the Army, despite a dramatic reduction in troops headed to a war zone, still faces serious challenges trying to reach and treat soldiers with post-traumatic stress disorder (PTSD) and other mental health conditions.

Opinion: People Link Killing Rampages To PTSD Due To Colossal Misinformation

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The alarming news of another military service member going on a shooting rampage killing and wounding other service members on a military base is unnerving. For us Latinos it is especially upsetting to know that Iván López, a Latino, perpetrated the recent Ft. Hood shooting. I do not care for highlighting a person’s ethnicity or culture in these tragic events, but I feel that I have a responsibility as a Latina, a veteran, and a mental health professional to state the obvious that others are already commenting on.


Update on Medications for PTSD

While psychotherapy remains the gold standard for treatment of post traumatic stress disorder (see for example, Foa EB et al, Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press; 2008), medications are often used to alleviate the symptoms of the illness. Since we last visited the topic of pharmacologic treatment for PTSD (TCPR, June 2007), there’s been some interesting research on this subject, including the use of antibiotics, steroids, and even the drug of abuse, ecstasy.

Cognitive Behavior Therapy for Posttraumatic Stress Disorder


Only a minority of individuals exposed to trauma will develop PTSD.  In attempting to determine the individual risk factors for PTSD, researchers have begun to observe natural recovery from trauma. One potential difference between those who recover naturally and those who continue to experience distressing symptoms might have to do with avoidance: cognitive, emotional and behavioral.

The cognitive model suggests that the belief that the world is excessively dangerous coupled with beliefs about personal incompetence is important in the development of PTSD (Foa & Rothbaum, 1998). Following a traumatic event, such beliefs might be reinforced and therefore lead to avoidance of everyday, previously normal tasks such as grocery shopping, socializing, and traveling by car. Additionally, beliefs about the importance of maintaining strict control over distressing emotions and thoughts might also be factors mediating the development of PTSD (Ehlers & Clark, 2000).  Following a traumatic event, these beliefs might lead to attempts to avoid thoughts and memories of the traumatic event and the associated upsetting emotions.

In contrast, natural recovery from trauma might be enhanced by a willingness to return, over time, to normal activities. This behavior may strengthen beliefs about personal ability to manage difficulty, that other people are not generally dangerous, and that even extremely uncomfortable emotions are manageable.

One CBT approach for PTSD systematically and strategically recreates this recovery process by targeting the tendency to avoid feared situations and distressing recollections and emotions.  By systematically approaching the avoided stimuli, the individual can learn the same lessons as the person who recovers without intervention.  With the assistance of a skilled cognitive behavior therapist, individuals can acquire more accurate and helpful beliefs about themselves, others, and the world following the experience of a traumatic event.


Ehlers, A., & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345.

Foa, E.B., & Rothbaum, B.O. (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. New York: Guilford Press.

Post Traumatic Stress Disorder (PTSD): What is it?

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What is Post Traumatic Stress Disorder (PTSD)? 

June is Post Traumatic Stress Disorder (PTSD) Awareness Month. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), PTSD is classified as an anxiety disorder. The forthcoming new DSM has reclassified it as a trauma based condition. PTSD includes features of anxiety such as generalized anxiety and dread. However, experiencing major stress is significant in developing PTSD. PTSD has a clear cause which is a specific, extreme trauma such as rape, violence, natural or man-made disasters such as hurricanes or 9/11, combat war, death of a loved one, car or other accidents, and humanitarian crisis. This extreme trauma is a horrifying and exceptionally stressful experience or event which is usually perceived as life threatening and not within the normal boundaries of day to day living. It leads to severe and uncontrollable psychological symptoms. It is extremely important that the general public understand that PTSD is a NORMAL response to an extremely ABNORMAL situation. Neuroscience has shown that trauma causes specific changes in the brain that requires treatment. It does not mean an individual is insane, dangerous, immoral, has a character flaw, or any other unfounded stigma that is unfortunately associated with PTSD due to misinformation or ignorance. Read more at