Too many war veterans avoid seeking help for their post traumatic stress disorder. A Department of Veterans’ Affairs trial conducted by the Australian Centre for Posttraumatic Mental Health in Victoria has identified the top five reasons why. They are:

• Difficulty accepting that they have a mental health problem;
• Uncertainty about what help is available;
• Concerns about stigma;
• Mistrust of health professionals; and
• A belief that ‘I should be able to handle this alone’.

Seizing on those findings, the initiative developed and trialled some innovative ways to encourage veterans and former serving members in the Barwon South-Western Health Region to seek help with their mental health problems.

Results of the trial are yet to be released, but ACPMH psychologist Andrea Phelps told a DVA research seminar last week that the trial’s intervention goals and key messages were:

1. Increase awareness of mental health issues, services and benefits of treatment
- you can feel more like your old self and enjoy life;
- it’s never too early nor too late to get help
2. Increase acceptability of mental health care
- you’re not alone
- it takes courage to get help
3. Increase accessibility of mental health care
- treatment is available locally
- if you have someone you are concerned about they may need a nudge to get the help they need.

The trial’s website: http://howareyoutravelling.org.au/

This model is similar to the approach adopted in Picking Up The Peaces’ Strategic Plan a year ago, and we have opened discussions for access to findings and lessons learned.

Treatment Best Practice

The DVA Research Seminar also included updates on the implementation of PTSD best practice in VVCS, and Cognitive Processing Therapy (CPT).

Anne-Laure Couinueau, who leads the DVA Training for Mental Health Practitioners Initiative at ACPMH, said that about 25% of people with PTSD receive ‘evidence-based treatment’, compared with 20% in the US.

She said they’d found that the old model of disseminating research findings to practitioners was not sufficient, because practitioners tended not to adopt the recommended best practice.

One reason was that the recommended exposure therapies (de-sensitisation)were painful to both the patient and the practitioner.

Practitioners tended to doubt their own competence, and coupled with a concern for their clients, that was a major limitation on adoption of best practice.

In future, practitioners and clients will be encouraged to generate strategies that suit the individual. The team will evaluate a model that seeks to engage staff and management, identifies barriers and incentives, and provides training and followups.

CPT

Psychology researcher Delyth Lloyd said the joint ACPMH-VVCS Cognitive Processing Therapy study examines the effectiveness of CPT as a potentially potent treatment for combat-related PTSD in Australian veterans. It also seeks to establish whether community based clinicians such as VVCS counsellors can be effectively trained in CPT and apply it in VVCS centres.

She said Cognitive Behaviour Therapy (CBT) and CPT are the gold standard therapies for PTSD. This, however, is the world’s first community trial of CPT.

CPT targets five primary themes – safety, trust, power, self-esteem and intimacy. What appeals to clients is that is a time-limited treatment – 12 sessions – rather than an open-ended arrangement.