Comments on: Mis-Treating Our Veterans http://www.scienceline.org/2007/02/28/policy_romero_ptsd/ The Shortest Distance Between You and Science Sun, 14 Mar 2010 11:38:46 -0400 http://wordpress.org/?v=2.8.4 hourly 1 By: Christine M. Fahrenbach http://www.scienceline.org/2007/02/28/policy_romero_ptsd/comment-page-1/#comment-1878 Christine M. Fahrenbach Sun, 15 Jun 2008 02:39:49 +0000 http://scienceline.org/2007/02/28/policy_romero_ptsd/#comment-1878 What about EMDR which has been demonstrated to be very effective with some sx of PTSD. A furhter explanation of CPT would make this article more useful. Thanks. Chris What about EMDR which has been demonstrated to be very effective with some sx of PTSD. A furhter explanation of CPT would make this article more useful. Thanks. Chris

]]> By: Marnie Flynn http://www.scienceline.org/2007/02/28/policy_romero_ptsd/comment-page-1/#comment-1462 Marnie Flynn Wed, 05 Mar 2008 19:40:17 +0000 http://scienceline.org/2007/02/28/policy_romero_ptsd/#comment-1462 What about Cognitive Processing Therapy? Does that fall under the umbrella of CBT? What about Cognitive Processing Therapy? Does that fall under the umbrella of CBT?

]]> By: Wayne Hankammer http://www.scienceline.org/2007/02/28/policy_romero_ptsd/comment-page-1/#comment-917 Wayne Hankammer Tue, 19 Jun 2007 23:41:05 +0000 http://scienceline.org/2007/02/28/policy_romero_ptsd/#comment-917 Clearly this is an important subject for the foreseeable future is the care of those exposed to trauma. Happily, there are treatments that certainly work on trauma. But, there seems to be a few inconsistencies with this report. One is that it sees psychiatrists and their medical training which may be confused with the other term, “clinician” which will include a wide variety of disciplines. The other term used was “traditional psychotherapy”. Since there are numerous orientations to therapy the term has little meaning and could include the cognitive-behavior segment, which itself is quiet a broad-brush. Backing any psychotherapy with scientific data is generally what people want to see; something quantifiable. Taxpayers are generally content if money is spent on something with a track record. However, there are other therapies that do help. There is a family of therapies that addresses the traumatic nightmare portion of PTSD. Krackow, Kellner, Neidhardt, Pathak, & Lambert, pioneered the concept of Imagery Rehearsal Therapy (IRT) that they reported in 1993. They showed the treatment is effective 68% of those treated (n=19) reduced the frequency of chronic nightmares 30 months after treatment. In effect, the frequency dropped to one per month or less. In 1995 Thompson, Hamilton, & West, adapted the treatment for group treatment for nightmares in veterans at the New Orleans VA Medical Center and published the results in the National Center for PTSD Clinical Quarterly (Fall), 1995. Spoormaker, et al (2003) compared IRT to lucid dreaming concluding both reduce nightmare frequency and weakens the fright. Forbes, et al (2003) reported in the pilot study that 7 of 12 veterans ridded themselves of all nightmares. The frequency and intensity of the target nightmares and of other nightmares all dropped dramatically. Meanwhile their sleep efficiency, quality and quantity all improved. In another study, Krakow, et al (2001) determined the therapy was effective for use in sexual assault survivors as well. However, like the article by Mr. Romero, IRT requires some training. It is brief, effective and targets the trauma in a manner similar to exposure therapy. Perhaps there should be more research into this area. Clearly this is an important subject for the foreseeable future is the care of those exposed to trauma. Happily, there are treatments that certainly work on trauma. But, there seems to be a few inconsistencies with this report. One is that it sees psychiatrists and their medical training which may be confused with the other term, “clinician” which will include a wide variety of disciplines. The other term used was “traditional psychotherapy”. Since there are numerous orientations to therapy the term has little meaning and could include the cognitive-behavior segment, which itself is quiet a broad-brush.

Backing any psychotherapy with scientific data is generally what people want to see; something quantifiable. Taxpayers are generally content if money is spent on something with a track record. However, there are other therapies that do help.

There is a family of therapies that addresses the traumatic nightmare portion of PTSD. Krackow, Kellner, Neidhardt, Pathak, & Lambert, pioneered the concept of Imagery Rehearsal Therapy (IRT) that they reported in 1993. They showed the treatment is effective 68% of those treated (n=19) reduced the frequency of chronic nightmares 30 months after treatment. In effect, the frequency dropped to one per month or less. In 1995 Thompson, Hamilton, & West, adapted the treatment for group treatment for nightmares in veterans at the New Orleans VA Medical Center and published the results in the National Center for PTSD Clinical Quarterly (Fall), 1995. Spoormaker, et al (2003) compared IRT to lucid dreaming concluding both reduce nightmare frequency and weakens the fright. Forbes, et al (2003) reported in the pilot study that 7 of 12 veterans ridded themselves of all nightmares. The frequency and intensity of the target nightmares and of other nightmares all dropped dramatically. Meanwhile their sleep efficiency, quality and quantity all improved. In another study, Krakow, et al (2001) determined the therapy was effective for use in sexual assault survivors as well.

However, like the article by Mr. Romero, IRT requires some training. It is brief, effective and targets the trauma in a manner similar to exposure therapy. Perhaps there should be more research into this area.

]]> By: Piers Bishop http://www.scienceline.org/2007/02/28/policy_romero_ptsd/comment-page-1/#comment-719 Piers Bishop Wed, 28 Feb 2007 09:17:02 +0000 http://scienceline.org/2007/02/28/policy_romero_ptsd/#comment-719 In the UK CBT is one of the government's recommended treatments for PTSD, but in truth it does not work very well, and so people are still encouraged to believe that PTSD is often a lifetime condition. However, in the time it has taken for CBT to build its popularity much better treatments for PTSD have emerged. For example, the Rewind technique has been deeloped to the point where it has an extremely high success rate and usually completely alleviates the nightmares, panic attacks, flashbacks, etc associated with PTSD. This technique was developed by Joe Griffin and Ivan Tyrrell and is based ultimately on an idea of Milton H. Erickson's. It is rapid, reliable and non-voyeuristic in that the therapist does not have to hear all the details of the trauma, which makes it particularly useful in cases of abuse. For a summary of the technique see www.themeadowpractice.co.uk/trauma.html . There are some small studies of the results from this technique under way, including some within our National Health Service as some units have started to use the technique on their own initiative, but as yet there has not been a randomized controlled trial because of the very high cost. And even when an RCT has been done, it could still be 30 or 40 years before the Rewind is considered a normal part of the armoury against PTSD, because of the inherent resistance to change in any profession. As Max Planck pointed out, science advances funeral by funeral! In the UK CBT is one of the government’s recommended treatments for PTSD, but in truth it does not work very well, and so people are still encouraged to believe that PTSD is often a lifetime condition. However, in the time it has taken for CBT to build its popularity much better treatments for PTSD have emerged. For example, the Rewind technique has been deeloped to the point where it has an extremely high success rate and usually completely alleviates the nightmares, panic attacks, flashbacks, etc associated with PTSD. This technique was developed by Joe Griffin and Ivan Tyrrell and is based ultimately on an idea of Milton H. Erickson’s. It is rapid, reliable and non-voyeuristic in that the therapist does not have to hear all the details of the trauma, which makes it particularly useful in cases of abuse. For a summary of the technique see http://www.themeadowpractice.co.uk/trauma.html . There are some small studies of the results from this technique under way, including some within our National Health Service as some units have started to use the technique on their own initiative, but as yet there has not been a randomized controlled trial because of the very high cost. And even when an RCT has been done, it could still be 30 or 40 years before the Rewind is considered a normal part of the armoury against PTSD, because of the inherent resistance to change in any profession. As Max Planck pointed out, science advances funeral by funeral!

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