Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that continues to raise critical questions concerning the legal aspects of certain treatment approaches that are approved by the federal government. Consequently, the legal feature of the treatment remedies for PTSD focuses on, in the light of the federal government, both legal and illegal treatments. Evidentially, reports related to both legal and illegal PTSD treatments remain helpful to Department of Veterans Affairs (VA) leaders because of their potential to adapt to evidence-based practices, especially in PSTD screening practices for vulnerable veterans. Training accorded to the care providers has become pivotal regarding PTSD veterans making appropriate care decisions.
Adoption of Evidence-Based Practices
Alexander (2012), emphasized veterans suffering from PTSD to have access to Food and Drug Administration (FDA) approved drugs, including paroxetine in conjunction with selective serotonin reuptake inhibitors (SSRIs) to manage their condition. Functionally, veterans take the drugs which affect a certain target organ in the body that helps in the regulation of bodily processes, including mood changes, sleep, and appetite among others. Additional studies conducted to confirm the effectiveness of the FDA approved drugs show that the use of sertraline in patients suffering from PTSD was more effective than the placebo (Alexander, 2012). Accordingly, VA therapists undergo training in Cognitive Processing Therapy or Prolonged Exposure because some veterans prefer to undergo psychosocial treatment over medication (Reisman, 2016). Such evidence-based practices have been deemed legal by the federal government because of their effectiveness and time-limited nature. Interestingly, evidence-based applications are steering veterans away from those practices that have a strong evidence base. By adopting evidence-based principles in their work, clinicians have managed to create integration in their treating models by combining the PTSD treatment models. Accordingly, the practices accord veterans timely access to medical care within and outside VA programs. Progressively, the veterans’ health program receives the necessary attention because of the unique opportunities, which result from the integration of the treatment models achieved by combining the PTSD treatment approaches. Furthermore, PTSD screening practices remain beneficial to veterans because individuals who are vulnerable to risk factors of developing the PTSD condition become apparent. Caregivers can channel preventive efforts toward the implementation of appropriate responses against vulnerable veterans in a timely manner because unidentified cases are also discovered in the process (Alexander, 2012).
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Evidence-based practices have also been adopted by VA leaders because they proved helpful in analyzing the impacts associated with wearable motion-sensing technologies concerning the veterans’ physical activity. Furthermore, the practices are helpful for comparing the effectiveness of proton irradiation therapy procedures during the intervention. The reports given by the doctors serve as a strong case during the critical evaluation of the policies and programs of evidence-based practices, because of their usage in randomized trials (Polak et al., 2012). Nonetheless, further research indicates that doctors embrace the use of new opportunities presented by other scientists aiming at improving the healthcare of veterans across the country. The collaboration shown by most doctors regarding the use of evidence-based practices is proof of the legality of any treatment mode applied to PTSD. The combined effort confirms the possibility of having a healthy population of veterans suffering from PTSD entitled to hospitalized instead of the unreliable home care options.
Training of care providers
The health and wellbeing of the veterans is a subject which continues to draw the attention of appropriate healthcare reforms nationally. The evidence of healthcare reforms shows the effectiveness of PTSD treatments among veterans and they justify the implementation of training programs targeting care providers across the country. Treatment approaches regarded as illegal by the federal government remain a subject of interest for many doctors focusing on PTSD treatments. Nonetheless, the treatments are illegal, but they have psychotherapeutic benefits for veterans suffering from all stages of the PTSD condition (Frood, 2008). Methylenedioxyphenyl-methylamphetamine (MDMA), known as ecstasy, is a controversial drug which the federal government flags as illegal, but it helps ease the effects of PTSD among the veterans who refer to it as a potential adjunct to normal psychotherapy. Conversely, Frood (2008) disputes that information on MDMA bases on a small pilot study which lacks substantial reliability measurements. Consequently, extensive research is necessary to approve illegal treatment remedies proposed for usage against PTSD patients for all veteran circumstances anywhere in the country.
The training of caregivers is an element that needs to be considered because it leads to the combination of cognitive behavioral therapy procedures and treatment with drugs like paroxetine. Combination of PTSD treatment approaches shortens the recovery period of veterans just to a few months, contrary to using a single treatment method (Frood, 2008). Consequently, illegal treatments have not been given much focus because training has managed to eliminate all the queries of PTSD veterans.
Additionally, training has enabled the veterans to address high priority PTSD incidences common among patients through embracing current technological innovations. Consequently, the technological innovations enable veterans to acquire behavioral health services, especially for patients recently diagnosed with PTSD. According to Reisman (2016), telehealth telecommunications technology is both convenient and destigmatizing. Practically, telehealth innovation best suits rural areas because most VA enrollees reside in such environments (Reisman, 2016). Studies have shown that through receiving psychotherapeutic services through the phone, many adhere to appropriate treatments. Moreover, others have gone a step ahead and initiated personalized treatment schedules, which is a critical component of patient recovery. Consequently, veterans can draw on such a relationship to improve their PTSD recovery path when undergoing treatment, because they need a healthy, emotionally, and physically stable atmosphere.
PSTD Treatments for Veterans
A research by Sharpless and Barber (2011) analyzes prevalent psychological and pharmacological interventions applicable for prevention and treatment of veterans with PSTD. Evidently, the application of various therapies such as Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure (PE) and Cognitive Processing Therapies (CPT) provide viable experimental data for PSTD treatment efficiency. The most excellent way to curtail the impacts of PSTD is to prevent it from developing after the occurrence of a particular traumatic incident. Prevention can be done using psychological and pharmacological therapies. According to Sharpless and Barber (2011), pharmacological methods assessed for PSTD prevention include cortisol, ketamine, propranolol, beta-blocker, etc. From these approaches, beta-blocker and Propranolol are more likely to be promising. They help in treating performance anxiety, headaches, and high blood pressure. Research shows that these pharmacological approaches indicate varied results. Only two of them indicate minimization of PSDT.
The purpose of developing Psychological Debriefing was to prevent lasting negative consequences of the traumatic incident aftermath.
The regular prevention practices include normalizing responses, extracting emotional responses and being ready for the PSTD reactions (Sharpless & Barber, 2011). Even though the psychological debriefing is extensively applied, evaluation of current RCTs provided insufficient evidence to indicate that it helps in preventing PSTD. Actually, the analysis indicates that it can cause harm to asymptomatic people. Psychological debriefing intervention benefits symptomatic patients only.
Veterans with PSTD can be treated using Psychotropic medicines. It is less time demanding than psychotherapy. Moreover, any health care practitioner can administer it, unlike psychotherapy that requires a mental health practitioner. Nonetheless, existing PTSD guidelines advocate for the application of pharmacotherapy alongside psychotherapy.
Prolonged Exposure (PE) is one of the psychotherapies applied for PSTD treatment. It intends to minimize PSTD through conversion of the structures of memory hiding emotions like pervasive fear. It involves asking the client to imagine the traumatic events, recite them loudly, and discussing the events after reciting.
CPT therapy utilizes a number of emblematic elements of CBT. This therapy centralizes specifically on self-blame. It involves asking the clients to write down their experience, read the writing on their own and during therapy sessions loudly.
EMDR uses the Adaptive Information Processing theory that states that the memories of traumatic experiences are not processed and kept as memories. This therapy advocate for the imposition of positive memories on the client’s mind.
The Efficacy of Recommended Treatments for Veterans with PTSD
Psychotherapy interventions are very crucial for PTSD prevention and treatment. According to (Haagen, Smid, Knipscheer, and Kleber (2015), it is one of the most recommended approaches for PTSD. Veterans and military with Post Traumatic Stress Disorder (PTSD) gain less help from recommended psychotherapeutic treatment as compared to other people (Haagen, Smid, Knipscheer & Kleber, 2015). This is because traumatic experiences are more complex in the military field. From meta-analysis, it can be concluded that recommended interventions like Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure (PE) and Cognitive Processing Theories (CPT) are less effective for veterans.
However, CPT and Exposure therapy are more preferred for Veterans than Stress Management Therapy (SMT) and EMDR. While Exposure therapies expose the clients to the main cause of their fear and stress, CPT centralizes on altering the client's socially impaired thoughts (Haagen, Smid, Knipscheer, Kleber, 2015). These therapies can be applied alongside Pharmacological interventions to increase the efficacy. There are various medicines suggested or PTSD treatment including various types of antidepressants, benzodiazepines, and antipsychotic medicines. Antidepressants are used to treat depression, anxiety, and headaches. Antipsychotics, on the other hand, are combined with other medicines to treat more complicated and chronic PTSD symptoms.
Conclusion
Treatment of veterans suffering from PTSD remains the subject of many controversies because of the legal and illegal approaches involved in the process. However, many studies emphasize the need for training care providers in all treatment settings to widen the treatment scope received by veterans. While illegal treatment approaches are not popular, research should be extensively conducted to avail information on the potential aspects of non-FDA approved drugs used in the management of PTSD. Overall, veterans deserve to live free from PTSD just like any other normal citizen. Lastly, training should encourage veterans to embrace innovative technology throughout their recovery process.
References
Alexander, W. (2012). Pharmacotherapy for post-traumatic stress disorder in combat veterans . Journal for Managed Care and Hospital Formulary Management , 37 (1), 32-38. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278188/
Frood, A. (2008). Illegal drug shows promise in treating trauma symptoms. International Weekly Journal of Science . Retrieved from https: //www.nature.com/news/2008/081113/full/news.2008.1229.html
Haagen, J. F., Smid, G. E., Knipscheer, J. W., & Kleber, R. J. (2015). The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis. Clinical Psychology Review , 40 , 184-194.
Polak, A.R., Witteveen, A. B., Visser, R. S., Opmeer, B.C. Vulink, N., Figee, M., Denys, D. & Olf, M. (2012). Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: Design of a randomized controlled trial. BMC Psychiatry , 12, 166. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539952/
Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next . Journal for Managed Care and Hospital Formulary Management . 41 (10), 623-627. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/
Sharpless, B. A., & Barber, J. P. (2011). A clinician's guide to PTSD treatments for returning veterans. Professional Psychology: Research and Practice , 42 (1), 8.
