PTSD Treatment in the Veterans Affair’s System
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Treatment of Post-Traumatic Stress Disorder in the Veterans Affairs (VA) system is a quizzical conundrum. Miles of red tape and long wait times have made seeking treatment difficult to put it lightly. Following along with that is an issue that is gaining the spotlight more and more on a national level. Psychotherapy versus medication. On one hand we see the stressed VA system handing out pills like candy, it is much better time wise to simply give a few bottles of pills and send them on their way then to undergo time consuming psychotherapy. What I would like to examine with the report is not if such behavior is fair to the men and women who served our country, but rather what would be the best treatment for those men and women.
We cannot look into psychotherapy verse medication without also looking into alternate forms of therapy. While the VA stance on Alternative Therapy is still up in the air many veterans look for this form of treatment due to the inability to receive regular psychotherapy. Alternative therapy encompasses a very broad range of different types of homeopathic medicine. For our purposes I would like to focus on only a few, namely Acupuncture, guided relaxation and meditation. These forms have been studied more extensively then other forms and while not the most popular form of alternative therapy they are the ones that show the most promise of truly helping veterans overcome and adjust to their new life with post-traumatic stress disorder.
Therapy versus Medication
With the current numbers of veterans returning from combat with PTSD ranging from “8% to over 20% (Tuerk 161) the VA is having a rough time caring for them all. The standard medication response requires 3 different types of medicine on a daily basis. One for anxiety, one for affective symptoms such as insomnia and depression and one for re-experiencing symptoms such as nightmares and hypervigilance. Notice that none of these are truly treating the PTSD, they are only moderating the symptoms. The real big issue with this is the need for constant dosage adjustments, the human body response to these medicines by lowering the body’s natural defenses and chemicals that they mimic, requiring that the dosages be raised many times before they become effective. Add that to the long wait times at clinics and hospitals due to the large influx and what you have is a large group of people under medicated who have been told to resume normal life.
In contrast psychotherapy does not treat the symptoms in a chemical way, rather during sessions of standard therapy the veteran is asked to relive and gain an understanding of what happened in an environment that is meant to calm and provide at the very least a sense of safety. During this process the veteran is not normally given any medications, as such it also creates a problem of safety for the veteran, who is now bringing up and relieving horrible memory’s and not give any help in coping with them outside of treatment with the doctor. Many veterans have expressed that a civilian doctor has no way to truly understand a military mindset and thus cannot help comfort someone who has lived the more horrific aspects of it. It has been said that “[T]herapists need to develop cultural competence to work ethically with this group [veterans]” (Iacovou 182).
While many people use these types of therapy, they have little to no clinical testing and study complete that shows there effectiveness for treating PTSD.
Luckily there is some hope for veterans. As this problem has become more and more public the response by the VA was to reevaluate how they are treating the veterans that can be seen with the personal they have. Since early 2014 VA staff are being given instructions that both medication and therapy are to be given whenever possible. There new goal is to train and staff enough personnel in order to made that police viable.
Alternative Therapy
Since the term alternative therapy is use here I feel I should define it better. It is any form of therapy that is not recognized by a governing body as medical. It is also referred to as “complementary and alternative medicine” (Strauss 1) or CAM for short. While many people use these types of therapy, they have little to no clinical testing and study complete that shows there effectiveness for treating PTSD. That has not stopped many veterans from trying them in the hopes where the system has failed it would succeed.
Acupuncture is a traditional Chinese medical treatment where needles are placed in the subcutaneous tissue. The hope is to restore order and balance in the body systems. While a few studies have been completed on this none have met the need for empirical evidence required for it to be considered a treatment option by modern western medical professionals.
Relaxation is closely related to meditation. While relaxation is targeting your major muscle groups, meditation is mean to target your mind and mental images. Both have been show in studies to me incomplete as a complete treatment option. The studies that have been accomplished thus far have been flawed due to improper control groups and lack of a definition of dosage. It is worth a moment of time to note that even with the flawed study, it is suggested by many medical professionals to add meditation and relaxation to your daily routine to assist your primary treatment option.
Conclusion
While the outlook might seem grim for many returning veterans efforts are being made by both politicians and non-profit groups to increase the availability of treatment for all the veterans that need it.
We cannot look into psychotherapy verse medication without also looking into alternate forms of therapy. While the VA stance on Alternative Therapy is still up in the air many veterans look for this form of treatment due to the inability to receive regular psychotherapy. Alternative therapy encompasses a very broad range of different types of homeopathic medicine. For our purposes I would like to focus on only a few, namely Acupuncture, guided relaxation and meditation. These forms have been studied more extensively then other forms and while not the most popular form of alternative therapy they are the ones that show the most promise of truly helping veterans overcome and adjust to their new life with post-traumatic stress disorder.
Therapy versus Medication
With the current numbers of veterans returning from combat with PTSD ranging from “8% to over 20% (Tuerk 161) the VA is having a rough time caring for them all. The standard medication response requires 3 different types of medicine on a daily basis. One for anxiety, one for affective symptoms such as insomnia and depression and one for re-experiencing symptoms such as nightmares and hypervigilance. Notice that none of these are truly treating the PTSD, they are only moderating the symptoms. The real big issue with this is the need for constant dosage adjustments, the human body response to these medicines by lowering the body’s natural defenses and chemicals that they mimic, requiring that the dosages be raised many times before they become effective. Add that to the long wait times at clinics and hospitals due to the large influx and what you have is a large group of people under medicated who have been told to resume normal life.
In contrast psychotherapy does not treat the symptoms in a chemical way, rather during sessions of standard therapy the veteran is asked to relive and gain an understanding of what happened in an environment that is meant to calm and provide at the very least a sense of safety. During this process the veteran is not normally given any medications, as such it also creates a problem of safety for the veteran, who is now bringing up and relieving horrible memory’s and not give any help in coping with them outside of treatment with the doctor. Many veterans have expressed that a civilian doctor has no way to truly understand a military mindset and thus cannot help comfort someone who has lived the more horrific aspects of it. It has been said that “[T]herapists need to develop cultural competence to work ethically with this group [veterans]” (Iacovou 182).
While many people use these types of therapy, they have little to no clinical testing and study complete that shows there effectiveness for treating PTSD.
Luckily there is some hope for veterans. As this problem has become more and more public the response by the VA was to reevaluate how they are treating the veterans that can be seen with the personal they have. Since early 2014 VA staff are being given instructions that both medication and therapy are to be given whenever possible. There new goal is to train and staff enough personnel in order to made that police viable.
Alternative Therapy
Since the term alternative therapy is use here I feel I should define it better. It is any form of therapy that is not recognized by a governing body as medical. It is also referred to as “complementary and alternative medicine” (Strauss 1) or CAM for short. While many people use these types of therapy, they have little to no clinical testing and study complete that shows there effectiveness for treating PTSD. That has not stopped many veterans from trying them in the hopes where the system has failed it would succeed.
Acupuncture is a traditional Chinese medical treatment where needles are placed in the subcutaneous tissue. The hope is to restore order and balance in the body systems. While a few studies have been completed on this none have met the need for empirical evidence required for it to be considered a treatment option by modern western medical professionals.
Relaxation is closely related to meditation. While relaxation is targeting your major muscle groups, meditation is mean to target your mind and mental images. Both have been show in studies to me incomplete as a complete treatment option. The studies that have been accomplished thus far have been flawed due to improper control groups and lack of a definition of dosage. It is worth a moment of time to note that even with the flawed study, it is suggested by many medical professionals to add meditation and relaxation to your daily routine to assist your primary treatment option.
Conclusion
While the outlook might seem grim for many returning veterans efforts are being made by both politicians and non-profit groups to increase the availability of treatment for all the veterans that need it.
Works Cited
Wangelin, Bethany C, and Peter W Tuerk. "PTSD In Active Combat Soldiers: To Treat Or Not To Treat." Journal Of Law, Medicine And Ethics: A Journal Of The American Society Of Law, Medicine And Ethics 42.2 (2014): 161-170. Philosopher's Index. Web. 25 Feb. 2015.
Iacovou, Susan. "Treating PTSD In Military Personnel: A Clinical Handbook." Existential Analysis 1 (2013): 182. Literature Resource Center. Web. 25 Feb. 2015.
Strauss, Jennifer L. PTSD Research Quarterly. 2nd ed. Vol. 23. White River Junction: National Center for PTSD, 2012. Print.
Wangelin, Bethany C, and Peter W Tuerk. "PTSD In Active Combat Soldiers: To Treat Or Not To Treat." Journal Of Law, Medicine And Ethics: A Journal Of The American Society Of Law, Medicine And Ethics 42.2 (2014): 161-170. Philosopher's Index. Web. 25 Feb. 2015.
Iacovou, Susan. "Treating PTSD In Military Personnel: A Clinical Handbook." Existential Analysis 1 (2013): 182. Literature Resource Center. Web. 25 Feb. 2015.
Strauss, Jennifer L. PTSD Research Quarterly. 2nd ed. Vol. 23. White River Junction: National Center for PTSD, 2012. Print.