Does the Department of Veterans Affairs want to help with PTSD?

Replies to This Discussion

Permalink Reply by John Maclean on December 6, 2009 at 1:14pm

There are studies that show the most effective treaments for PTSD are Cognitive Behavioural Therapy (CBT) and EMDR (Eye Movement Desensitization Reprocessing). There is evidence that CBT combined with Hypnosis is even more effective.In UK the organisations such as Combat Stress do not use hypnotherapy but rather rely on CBT and EMDF combined with counselling. In my clinic I use a combination of NLP, CBT and Hypnotherapy as well as Pattern Interruption. This has proved to be effective. http://www.thisisexeter.co.uk/news/Natural-reaction-unnatural-event...

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Permalink Reply by Kent Fullarton on December 7, 2009 at 9:40am

The reason these are the most effective modalities that are proven? These are the only modes tested by psychologists. No other modalities are included in studies, apparently because no matter what works, psychology is the answer.

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Permalink Reply by John Maclean on December 7, 2009 at 11:01am

As I understand it the studies done here in UK included Hypnotherapy, EFT, TFT as well as EMDR and CBT. I'm trying to find the link to the study published recently but it seems to be eluding me for the moment. As a Veteran myself I understand the need for effective therapies and believe that whatever works is good!
John

Kent Fullarton said:

The reason these are the most effective modalities that are proven? These are the only modes tested by psychologists. No other modalities are included in studies, apparently because no matter what works, psychology is the answer.

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Permalink Reply by Dennis Atkinson on December 7, 2009 at 12:14pm

I have read a couple of books published by one of the program therapists for the V.A. program. Hypnosis was apparently widely used after the Viet Nam war, and remains a small part of their program, although they now incorporate other modalities including EMDR.

From what I remember, their PTSD program is operated by psychotherapists and psychiatrists .... and the gist of what I picked up from my reading was that their belief is that only psychotherapists and/or doctors should use hypnosis.

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Permalink Reply by Stephanie Voss on December 7, 2009 at 3:45pm

I, too, will be very interested if you have any response that can help us find an efficient way to donate services to veterans. Coincidentally, I just set myself a deadline of Friday to post an offer on Craigslist and to contact the local Jewish veterans' organization and VFW to see about giving a talk.

Here's the thing about the VA -- it's a GOVERNMENT facility. DOD, no less. In other words, bureaucracy -- although we must remember that they are responsible to citizens and soldiers for supervising both the competence and fairness of their referals. When I went to the VA hospital here in Los Angeles, I was turned away because although I am a certified hypnotherapist I am not a licensed mental health professional. And without state licensing to turn to, how can they know if I am truly qualified? At any rate, I think perhaps non-military referrals may be the way to go.

Also, the rules for confidentiality dealing with the military (former as well as current service personnel) are different.

See this intringuing story from the New York Times today: http://www.nytimes.com/2009/12/07/us/07therapists.html.
(In the Military, Different Rules for Patient-Therapist Confidentiality.) Among the reasons hypnotherapy may be an attractive and viable alternative for soldiers are these: soldiers can come for "stress relief" without getting a diagnosis or label of PTSD and, even more importantly, we can work "Privacy Style" as Michele Beaudry calls it -- guiding a session to heal a memory without ever needing to hear it ourselves. We can also work with dream imagery and have an entire session & conversation about the "dream" rather than the "incident." All of this lends itself, I think, to a less formal attachment to the military organizations themselves.

Does that make sense?

Anyone have a good contact with an NGO?

Best wishes,

Stephanie

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Permalink Reply by John Maclean on December 7, 2009 at 4:00pm

The difference between the US and UK in this matter is striking. In UK we have various charities that offer therapy for PTSD victims and some use hypnotherapists. The main charity, Combat Stress does not as far as I know. We do not have a VA organisation in UK therefore other than the NHS (who favour CBT) the only alternatives are charities or the private sector. There is a campaign going on at the moment to get more help for sufferers of PTSD but whether it succeeds is yet to be seen!

Stephanie Voss said:

I, too, will be very interested if you have any response that can help us find an efficient way to donate services to veterans. Coincidentally, I just set myself a deadline of Friday to post an offer on Craigslist and to contact the local Jewish veterans' organization and VFW to see about giving a talk.

Here's the thing about the VA -- it's a GOVERNMENT facility. DOD, no less. In other words, bureaucracy -- although we must remember that they are responsible to citizens and soldiers for supervising both the competence and fairness of their referals. When I went to the VA hospital here in Los Angeles, I was turned away because although I am a certified hypnotherapist I am not a licensed mental health professional. And without state licensing to turn

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Permalink Reply by John Maclean on December 7, 2009 at 4:01pm

The difference between the US and UK in this matter is striking. In UK we have various charities that offer therapy for PTSD victims and some use hypnotherapists. The main charity, Combat Stress does not as far as I know. We do not have a VA organisation in UK therefore other than the NHS (who favour CBT) the only alternatives are charities or the private sector. There is a campaign going on at the moment to get more help for sufferers of PTSD but whether it succeeds is yet to be seen!

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Permalink Reply by Steve Lovold on December 7, 2009 at 4:19pm

I truly appreciate this discussion. I am a Gulf - War Veteran , that has experience with going to the V.A. My experience with the facility in Brentwood , personally caused me a great deal of frustration with how the V.A. facilitated treatment for P.T.S.D. , at that particular hospital.
I will be blunt here . My philosophy is, "whatever works, work it." The V.A. doesn't work in reguards to treatment for P.T.S.D. , to such a degree, that it is criminal. So, what I have done is become familiar and study treatments that are successful. That's why I choose to study Guided Imagery , Neuro - Linguistic Programming, Meditation , Yoga, Nutrition, Exercise, etc. As well as the therapist whom have had a large body of work in the field. One of these people is Ed Tick P.Hd. who has written on this subject a great deal, and who has been working with Veit-Nam Vet's for over thirty years now. I am aware of the training that he has tried to introduce to the D.O.D. About a year ago he meet with other doctors at Ft. Hood, and according to Ed Tick, his point of view is that they are totally overwhelmed, that's only one side of the situation.
For now I'll stop right there, however I look forward to further communication about this subject.
~ Thank you

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Permalink Reply by Michael Ellner on December 7, 2009 at 4:47pm

Way to go Stephanie,

One in Five returning vets will be at risk for suffering from mental health injuries and our challenge is to reach out them through their self-help and advocacy groups and demonstrate our effectiveness.

I believe the best way to reform the VA is from the Veterans Up -- If Vets find our services helpful, they have a vested interest in pressuring the VA- to pay for our services-- If we can get the veteran's advocacy groups to demand that we be included into VA-treatment system - We in turn can get the media to pressure the DOD/VA to expand their disability coverage to pay for our services-- Every One Wins--

By the way, Steve's experience is common - the DOD does not want to address PTSD (See below:)



Sep-01-2009 17:34
Fight for Vets with PTSD in the 9th Circuit Court

Tim King Salem-News.com
What does it mean to be a veteran today?


9th Circuit Court Chief Judge Alex Kozinski and Attorney Gordon Erspamer. Courtesy: C-SPAN

(SALEM, Ore.) - The groups Veterans for Common Senseand Veterans United For Truth took their case for Post Traumatic Stress Disorder to the 9th Circuit Court in San Francisco in August.

The groups are asking the court to order the Department of Veterans Affairs to reform the way it deals with disability claims for Post Traumatic Stress Disorder and Traumatic Brain Injury.

Science Daily writes, "Nearly 20 percent of military service members who have returned from Iraq and Afghanistan -- 300,000 in all -- report symptoms of post traumatic stress disorder or major depression, yet only slight more than half have sought treatment, according to a new RAND Corporation study."

According to the National Institute of Mental Health, "Approximately 7.7 million American adults age 18 and older, or about 3.5 percent of people in this age group in a given year, have PTSD." They state that, "PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years." NIMH reports that about 19 percent of Vietnam veterans experienced PTSD at some point after the war.

Attorney for Combat Veterans

Representing the veterans groups, Attorney Gordon Erspamer explained to the justices how veterans suffering from advanced war-related stress are dying before their cases can be approved.

Erspamer opened by saying, "The essence of this appeal relates to the VA's multiple failures to fulfill the statutory commands established by Congress to provide veterans with timely medical care and disability compensation, which has resulted in suicides and other tragic circumstances for our veterans."

He says veterans are, "struck at the outset by a fundamental disconnect between the district court's finding of facts - and its legal analysis."

Erspamer offered the details, of how 3,000 veterans die each year while their appeals are pending, that it takes 4.4 years on average to exhaust the due process in the VA, and that 85k veterans are on waiting lists for healthcare.

His statements about the various inequities suffered by veterans didn't fall on deaf ears, but a defensive mechanism in Chief Judge Alex Kozinski seemed to spark to life.

The Federal Defensive Mechanism

Kozinski compared the agonizing years and months during which veterans languish with complicated disorders, to the waiting periods for social security claims and immigration claims, thus offering no clear delineation whatsoever for the combat veterans.

"This is sort of the nature of life", Kozinski said.

It seemed clear that veterans were never the concern when the Justice said, "If we were to rule in your favor, how do you keep the federal courts from taking over every single agency in the federal government and running it?"

"I'm wiling to say that most agencies in the federal government do things that are not satisfactory to people; they are too slow, don't deal the issues, there are many complaints that people have against them."

Kozinski continued, "We've got lots of agencies that are slower than what people prefer."

Underscoring the mission of Veterans United For Truth and Veterans for Common Sense; one that is reasonable and logic based, Erspamer told Kozinski, "We are dealing with very egregious delays."

Kozinski brushed that off, saying, "The Social Security Administration had a series of cases dealing with time delays of 30 to 90 days."

Erspamer says American combat veterans lost in the underfunded and unregulated Veterans Administration wait for up to 12, 13 and 14 years.

"I didn't mean to suggest they were as slow", Kozinski replied.

It goes far beyond the contrast in timeframes, Erspamer says. With SSI a person has a right to attain council, and with the VA a veteran does not.

Veterans Judicial Review Act

There are not very many cases involving veterans since the Veterans Judicial Review Act of 1988 was launched. It was supposed to resolve an inequity that veterans had faced for generations.

Veterans advocates explain that for 125 years, beginning in the 1860's, there was no judicial recourse for veterans who were denied benefits. The Department of Veterans Affairs (DVA), formerly the Veterans Administration, was virtually the only administrative agency that operated free of judicial oversight.

According to uscourts.gov, "Veterans whose claims for benefits were denied by the Veterans Administration were afforded no independent review of DVA decisions and were denied the right afforded to many other citizens to go to court and challenge similar agency decisions. The Board of Veterans' Appeals provided the final decision of what could be a long, arduous adjudication process for a veteran's claim."

"The status quo of no judicial review of veterans claims persisted until an influx of post-Vietnam claims in the 1970s and 80's directed the spotlight on an adjudication process that was in obvious need of reform."

In spite of growing pressure from veterans advocates, the House Committee on Veterans' Affairs resisted as long as they could, efforts to alter the DVA's policies, which were often explicitly insulated from judicial review.

That was in 1988. Since then the United States has launched a series of wars, and many veterans advocates see the fight as nearly having reverted to stage one.

No Neutral decision makers in VA

"We're talking about emergency healthcare". Erspamer talked about the rash of suicides from veterans returning from Iraq and Afghanistan, "The record shows at least some veterans have been turned away from facilities."




"There is no emergency procedure to find any relief. The adjudication system doesn't even apply," Erspamer said.

Kozinski seemed to be unaware of the current situation regarding veterans, in spite of his position. He said to Erspamer, "If there is a medical situation they turn away, that is appealable.

Erspamer said, "Medical decisions are not appealable, the only procedure they have is called the Clinical Review Procedure which does not ever apply in this case."

Moreover, he says three aspects of the review have no time limits, and no assurance of reasonable or expeditious treatment. The actual process of review ends at the seventh stage, the VA itself is the agency with the ultimate power to decide. From the beginning, veterans are dealing with an agency with limited funds.

In the end, the attorney says it is hard to compare the Veteran's Administration to Social Security or Immigration, "You have to differentiate the VA from every other system," he said.

Kozinski then suggested that these claims have to be brought up one at a time, "Why isn't this raised as an individual claim, and properly taken to the Federal Circuit?"

"The claim in this case is that there are systemic delays," Erspamer said, as the judge discussed what could be interpreted as nothing less than a varying array of additional delay strategies.

Erspamer says there is no remedy for systemic delay.

He talked about a process in the Veterans Court called "Extraordinary Writs of Mandate".

He says in reviewing the record of veterans seeking extraordinary relief, it is revealed that, "Between 1998 and 2004 there were none heard. Then in 2005 there was one. In 2006 there were zero. In 2007 there were two, and that includes all types of writs".

The time has come for the court to act, these are not problems of recent origin.

Kovinski deferred submission of the case for a week, saying, "I'd like to see if there is a possibility of working something out in the case and I realize on this side of the table it is something that would require permissions and approvals."

"This is one of those things that is very difficult for a court to manage."

He encouraged the attorneys representing the two sides to seriously discuss the matter and also referenced an on-site mediator as a possibility of helping them work out the differences.

The court seemed reluctant to aggressively intervene, yet offered a measure of hope.

Many Americans may not be aware of the efforts of groups like Veterans for Common Sense and Veterans United for Truth and other emerging groups that sanely and consistently rally and lobby for the rights of the nation's veterans.

>Veterans United For Truth and Veterans for Common Sense v. Shinseki, Case # 08-16728, was heard by the Ninth Circuit Court of Appeals at 9:30 a.m. PT August 12th 2009, in San Francisco. The suit was first filed against Secretary Nicholson, then successively against Secretaries Peake and Shinseki.

Sources:

sciencedaily.com

uscourts.gov

nimh.nih.gov

c-spanarchives.org




xxx
Editorial: Troops suffering from PTSD should not be shunted aside
http://www.news-record.com/content/2009/11/24/article/editorial_tro...

Editorial: Troops suffering from PTSD should not be shunted aside
WEDNESDAY, NOVEMBER 25, 2009 (Updated 3:00 am)
What do you think?
1comment(s)Read other visitors' commentsand post your own.

An estimated one in five military personnel returning from tours in Iraq and Afghanistan exhibit symptoms of Post-Traumatic Stress Disorder, or PTSD.

But fears of being stigmatized and having careers wrecked prevent many from seeking needed counseling after returning to stateside assignments.

For Marines coming back to Camp Lejeune near Jacksonville, there was an added irritant. The base's PTSD clinic was housed in temporary trailers within earshot of training exercise machine-gun fire and bomb blasts. Hardly conducive to being treated for war-related stress trauma.

Whether it was an honest oversight or conscious downplaying of the importance of dealing with mental disorders, the military's response was uncaring and unacceptable. To make matters worse, base officials, without explanation, fired the civilian psychiatrist who repeatedly complained about the odd arrangement.

Although a more suitable location eventually was found, Rep. Walter Jones, R-N.C., whose district includes Camp Lejeune, wants the Department of Defense to investigate. As he correctly pointed out in an interview with the Associated Press, "If we're going to call on these soldiers and Marines and their families to keep going on these deployments, we better be prepared to help them when they come back."

The shooting rampage at Fort Hood, Texas, allegedly committed by an Army psychiatrist, has focused on who gives and receives treatment for war-related psychological problems.

Too often, the top brass considers fragile emotional wounds a lesser medical priority than the more obvious shattered bones or burned flesh.

The military must assure its personnel and their families that PTSD is taken seriously, rather than written off as a character flaw or sign of weakness.

What happened at Camp Lejeune did just the opposite.

=^..^=
In accordance with Title 17 U.S.C. Section 107, any copyrighted work in this message is distributed under fair use without profit or payment for non-profit research and educational purposes only.
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Steve Lovold said:

I truly appreciate this discussion. I am a Gulf - War Veteran , that has experience with going to the V.A. My experience with the facility in Brentwood , personally caused me a great deal of frustration with how the V.A. facilitated treatment for P.T.S.D. , at that particular hospital.
I will be blunt here . My philosophy is, "whatever works, work it." The V.A. doesn't work in reguards to treatment for P.T.S.D. , to such a degree, that it is criminal. So, what I have done is become familiar and study treatments that are successful. That's why I choose to study Guided Imagery , Neuro - Linguistic Programming, Meditation , Yoga, Nutrition, Exercise, etc. As well as the therapist whom have had a large body of work in the field. One of these people is Ed Tick P.Hd. who has written on this subject a great deal, and who has been working with Veit-Nam Vet's for over thirty years now. I am aware of the training that he has tried to introduce to the D.O.D. About a year ago he meet with other doctors at Ft. Hood, and according to Ed Tick, his point of view is that they are totally overwhelmed, that's only one side of the situation. For now I'll stop right there, however I look forward to further communication about this subject. ~ Thank you

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Permalink Reply by Melissa J. Roth on December 7, 2009 at 6:08pm

Joan Courtney, CHt. in Show Low, Arizona is working with the Veterans Hospital/Admin. in that area with Veterans for PTSD. And, the VA is paying her. She started working with one veteran and now that they have seen success they are referring more to her. She has been working with these vets through the VA Hospital there for over a year now. Also, Charlene Ackerman was seeing veterans with PTSD for the VA in Wisconsin. Unfortunately, she died in Sept. but she had been working with them for several months before she became ill. I"ve had a few other people at conferences tell me they are working with vets through the VA and being paid by the VA.

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Permalink Reply by ali atkins on December 9, 2009 at 12:39pm

It depends on what VA you go to. Some are HUGE on PTSD, and others are not so good. Also, some have good customer service, while others just keep transferring you to some other idiot.

I work at the VA but I also am seen at the VA for PTSD, and I've been to different VA's and they were all different.

The way around the people that don't have a clue is to register at the VA, get assigned a Primary Care provider (even if you're using a regular doctor outside the VA), and make an appointment with the PCP and they will put in a consult for your PTSD and you'll get rolling.

The services at the VA that I'm at are great. (and I say that as a patient, not an employee)

Email me at ali.atkins5@gmail.com and I can tell you more if you want. :)

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Permalink Reply by Kent Fullarton on December 10, 2009 at 3:55pm

Thank you everybody. I will keep trying to get hypnosis in the program. Getting politicians involved next. Then writing newspaper articles that will embarrass them into proving that it does not work.

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