For combat-related PTSD, resiliency programs are not enough

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After millions of dollars invested and thousands of hours of testing, a scientific panel at the Institute of Medicine of the National Academies has reported that the "resiliency programs" the Defense Department has so heavily invested in are not effective. They are, in fact, not "consistently evidence-based or are evaluated infrequently or inadequately," the panel found.

The good news? The programs may be working, in part, or may be working well as part of a larger regimen of treatment for soldiers with combat-related post-traumatic stress disorder (PTSD), but because there are few or no objective evaluations of the programs themselves, this cannot be said with certainty. Anecdotally, however, the programs often do work.

The Department of Defense is reviewing the IoM report, which as compiled at the DOD's request, in order to assess program effectiveness and changes that might be required. With about 936,000 veterans receiving a diagnosis for mental health conditions from 2000 to 2011, it's obvious that there is a need for programs like this.

These resiliency programs are meant to teach coping skills and positive thinking. Having attended some of these program meetings and therapy sessions as an observer, the author can attest to their usefulness for some people, but not for all. Often, the program's materials are presented in an almost school-like way to veterans, giving the impression these are "tests" to be "passed" in order to continue down the line of hoops to jump through. This institutionalization of the program may be it's greatest problem.

For the veterans who take it seriously, however, the resiliency exercises and workshops can be of great help. Those people, however, are the ones who've already consciously made a decision to participate and get well. Those who have not made this step forward, however, receive no perceived benefit, in my unprofessional opinion. The effectiveness of the program would be greatly improved were it to be more about showing the success and less about the steps to get there.

The IoM had other things to say about other parts of the program as well.

Whatever the Defense Department does, however, they need to do something positive. Despite planned budgetary cuts, the DOD needs to address its primary issue when it comes to active-duty and veteran soldiers' health: the extremely high suicide rate taking place right now. By their own estimation, the DOD says that about half of all active-duty and veteran soldiers returning or recently returned from Iraq or Afghanistan are likely to kill themselves in their lifetimes.

That is unacceptable and seems to indicate a serious flaw not only in the training being given to prepare troops for war, but in the carrying out of that war and its aftermath, including policies of multiple deployments and after-care those soldiers receive.

Resilience training can, perhaps, help, but is not likely enough. The IoM's panel review is a look at just one part of the overall Veteran's Administration health system and gives no insight into the military's current or recent deployment policies. That would require systemic review of the entire Department of Defense.

See more at the Army Times.


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