According to the U.S. Department of Veterans Affairs (VA), about 7-8% of the U.S. population will have Post Traumatic Stress Syndrome (PTSD) at some point in their lives. Although many more people go through some sort of trauma, approximately 5.2 million adults develop PTSD during any given year (VA, n.d.). 5.2 million is no small number, and 
clearly presents a problem worthy of discussion, and consideration for an applied social psychology intervention. Since many of these PTSD sufferers are military service members who suffer from combat related stress, this population seems like a good place to start.
“Army analysis of multiple studies suggests that most service members have at least one experience during deployment that could lead to PTSD, and 15 percent of U.S. infantrymen who have deployed to Iraq or Afghanistan have returned with the disorder, a condition characterized with such symptoms as depression, anger, mistrust, panic, guilt and violent behavior, physical pain, dizziness and trouble sleeping.” (Robinson, S., 2012)
The VA posits that cognitive behavioral therapy has been shown to be the most effective type of psychological counseling for PTSD. The VA currently provides two types of cognitive behavior therapy to Veterans with PTSD: Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy. PTSD sufferers often struggle with their memories about the traumatic events they witnessed. These persistent negative cognitions about the trauma can seriously affect the way PTSD sufferers act, and how they live their lives. CPT is intended to give sufferers new ways to understand the trauma they endured. By helping them become aware of their thoughts, feelings, and behaviors, practitioners have found PTSD patients find some relief from their symptoms. CPT also provides learning skills to help them process and deal with their negative thoughts. Therefore, CPT might be an effective technique to reduce PTSD symptomology in patients. Prior to developing an applied social psychology intervention to help PTSD sufferers, it would be helpful to first have a basic understanding how Cognitive Processing Therapy works.
Resick & Schnicke (1992) described that a theoretical underpinning of CPT is the information processing theory (IPT). They described IPT as the “process by which information is encoded, stored in memory, and recalled.” IPT-related research on PTSD (Lang, 1977) indicated, “information is stored in fear networks that consist of stimuli, responses, and the meanings of the stimulus and response elements. The network is viewed as a program to stimulate avoidance behavior.” Other research found that “fear reactions emanated from an appraisal of threat”, and that even ambiguous threat stimuli could trigger fight-or-flight responses (Beck & Emory, 1985). Additional volumes of research support the idea that the way PTSD patients process traumatic threat information affects how they subsequently think and behave. Basically, this research all points to the possibility that changing faulty cognitions can lead to positive change in PTSD symptomology. Perhaps this is why the VA website contends that cognitive behavioral therapies are considered to be so effective.
PTSD researchers, Resick, Monson, & Chard (2008) developed a CPT training manual for mental health practitioners and PTSD patients as a response to numerous research studies indicating the efficacy of CPT (e.g. Resick & Schnike, 1992). The CPT training manual seeks to change the thoughts and behaviors of PTSD patients through education, self-evaluation, and skills practice. Resick (2001), one of the manual’s authors has studied PTSD extensively, and believes “the etiology of PTSD can be addressed, leading to a potential “cure” to the condition.” However, the manual was intended to be utilized in face-to-face therapy sessions, and unfortunately, not all PTSD patients will take advantage of this type of face-to-face therapy due to fear of being labeled as mentally unfit.
“Soldiers in an all-volunteer force want to be selected for combat missions and they are afraid that psychological testing will prevent them from deploying” (Robinson, S., 2012)
For this reason, a possible way to successfully implement a PTSD intervention could be to utilize the Resick et al. (2008) training on the Internet. Using the Internet would ensure anonymity, and would allow the sufferer to participate in therapy at his or her own convenience. Perhaps even an online chat forum could be used to supplement the training. Advertisement in newspapers like the Stars and Stripes, Military Times, and other service-specific news outlets could successfully advertise this kind of intervention. Anonymous pre- and post-intervention self-report surveys could be used to assess PTSD symptomology using a reliable PTSD assessment measure to determine efficacy. To reduce potential drop-out rates, perhaps some sort of incentive could be also used to encourage sufferers to stay in the intervention.
Even if this intervention were only moderately effective at changing PTSD patients’ cognitions, perhaps it could still bring hope and comfort to some sufferers, and allow others to have a better understanding of the potential benefits of therapy.
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References:
Beck, A. T, & Emery, G. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.
Department of Veterans Affairs (VA), (n.d.). PTSD: National Center for PTSD website. Retrieved from http://www.ptsd.va.gov/index.asp
Lang, P. J. (1977). Imagery in therapy: An information processing analysis of fear. Behavior Therapy, 8, 862–886.
Resick, P. A. (2001). Cognitive therapy for posttraumatic stress disorder. Journal of Cognitive Psychotherapy: An International Quarterly, 15: 321–329.
Resick, P.A., Monson, C.M., & Chard, K.M. (2008). Cognitive processing therapy: Veteran/military version. Washington, DC: Department of Veterans’ Affairs.
Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60: 748–756.
Robinson, S. (2012). Soldiers fail to seek PTSD treatment or drop out of therapy early, research finds. Stars and Stripes Newspaper online. Retrieved from http://www.stripes.com/news/special-reports/post-traumatic-stress-disorder-ptsd/soldiers-fail-to-seek-ptsd-treatment-or-drop-out-of-therapy-early-research-finds-1.177275
What a brilliant resource for PTSD and any other individuals! I think there are as many great aspects as there are challenging ones. When it comes to therapy especially when someone needs intense help but they don’t need to be inpatient treatment …there is a gap that this program could fill! It can also help individuals that are waiting to return home but need to begin therapy immediately. Where this falls short…(and its just the nature of online-distance therapy and learning) is the person suffering from mental health issues is usually someone who finds simple daily tasks very challenging so getting the patient to participate or even turn on their phone for computer could be an issue. The same issue happens with provider appointments as well however that makes me think….maybe we should take another look at house calls from therapists and doctors? Hmmmm?! At any rate, I really think this is an important issue and a GREAT tool for military patients suffering with PTSD. Thank you so much for writing about it.
Your post and topic was a great example of positive uses for the Internet. I can see many great aspects of having help available for those suffering with PTSD because of the anonymity the Internet would provide as well as ability to conduct help during typical non-business hours. I would imagine that help is very often needed when typical counseling centers are not open. I think a great number of people fear judgment or possible loss of employment by openly admitting to any number of mental health issues. It is such a tragedy that the people fighting for our country feel unable to participate in any help or research due to fear of being labeled as mentally unfit. I thoroughly enjoyed reading your blog post and was able to learn from it.
I enjoyed reading through your post as I am studying psychology in the hopes of being able to become a therapist once I leave the Marines and specialize in PTSD in order to work with our veterans. There are online therapy programs currently available for people to use if they do not wish to be face-to-face with a therapist, however – I am not positive exactly on how effective they are with veterans suffering from PTSD. Another resourceful tool that is available are PTSD apps that individuals can download onto their smartphones. This allows the individual to track their symptoms in order to gauge 1) how many different symptoms they exhibit and 2) how often they exhibit the symptoms. The apps are pretty resourceful for information and knowledge as well.