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January 2017

Refining Trauma-Focused Treatments for Servicemembers and Veterans With Posttraumatic Stress Disorder: Progress and Ongoing Challenges

Author Affiliations
  • 1Center for Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
  • 2Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
JAMA Psychiatry. 2017;74(1):13-14. doi:10.1001/jamapsychiatry.2016.2740

Fifteen years of war in Afghanistan and Iraq have generated unprecedented investment in mitigating war-related mental health problems, including large increases in funding since 2007 for clinical trials of trauma-focused psychotherapies.1 This issue of JAMA Psychiatry includes one of the most important clinical trials to emerge from the Department of Defense and Veteran Affairs (DoD/VA) research portfolio, a large trial by Resick et al2 comparing individual and group cognitive processing therapy (CPT) in servicemembers with postdeployment posttraumatic stress disorder (PTSD).2 Group therapies of various types are frequently used in DoD/VA and other health care settings, despite limited evidence supporting their efficacy. Individual CPT and prolonged exposure therapy (PE) are the 2 evidence-based trauma-focused psychotherapies most widely used in DoD/VA facilities.3 However, in many locations, access to individual trauma-focused treatment is limited owing to lack of resources and/or trained personnel. Cognitive processing therapy lends itself well to group delivery through a highly manualized approach with worksheets and Socratic questioning focused on restructuring trauma-related cognitions. Effective group therapy for PTSD would open the door to more efficient care for larger numbers of patients, making this study a high priority.

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