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Family Interventions in the Treatment of PTSD in OEF/OIF Veterans Frederic Sautter, Ph.D. Family Mental Health Program Southeast Louisiana Veterans Health Care System. Why is it important to provide family treatment to OEF/OIF veterans with PTSD?.
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Family Interventions in the Treatment of PTSD in OEF/OIF VeteransFrederic Sautter, Ph.D.Family Mental Health ProgramSoutheast Louisiana Veterans Health Care System
Why is it important to provide family treatment to OEF/OIF veterans with PTSD? • Reexperiencing Symptoms – Creates psychological distance between the veteran and the family member. • Avoidance/Emotional Numbing – Contributes to isolation and a loss of emotional expression. • Hyperarousal – Contributes to conflict and aggression.
Why is it important to provide family treatment to OEF/OIF veterans with PTSD? Because PTSD is devastating to relationships… • Combat veterans with PTSD are twice as likely to be divorced as non-PTSD veterans, and three times as likely to have multiple divorces. • Combat veterans with PTSD are more likely to have interpersonal problems than non-PTSD veterans. • Veterans with PTSD are more likely to perpetrate verbal and physical aggression against partners and children, with rates as high as 63% over a one-year period. • Partners of PTSD veterans report high levels of distress and demoralization.
Top 5 Referral Issues – U.S. Army • Couple’s Issues 51.9% • Depression 18.1% • Counseling 11.9% • Family Relations 9.2% • Stress Management 9.0%
Top 5 Referral Issues –Louisiana National Guard • Couple’s Issues 47.5% • Stress Management 15.0% • War Issues 15.0% • Depression 12.5% • Counseling 10.0%
What are the benefits of providing family intervention to traumatized OEF/OIF veterans? • Reduce family and marital distress. • Increase family and spousal support. • Reduce PTSD symptoms and problems. • Promote PTSD treatment engagement.
Couples and family interventions may be used to engage the OEF/OIF veteran in PTSD treatment because… • OEF/OIF veterans who are reluctant to seek treatment for PTSD may accept help for their relationship problems. • The spouses and family members of OEF/OIF veterans may encourage them to accept family or couple’s treatment. • OEF/OIF veterans may be assured that a goal of family and couple’s treatments will be to provide them with a more supportive and understanding family environment.
What empirically-based treatments are appropriate for traumatized OEF/OIF veterans and their families? • Family psychoeducation • Couple’s therapy • Behavioral Couple’s Therapy • Couple’s Cognitive Behavior Therapy
Family psychoeducation was developed to reduce “expressed emotion” in families of schizophrenics. “Expressed emotion” is defined as… • Criticalattitude toward the patient. • Hostileattitude toward the patient. • Emotionaloverinvolvement (e.g. dramatic, highly reactive)
Family psychoeducation has been shown to reduce “expressed emotion” in families and to reduce psychotic relapse by 30-50%, controlling for medication effects.
Exactly what does family psychoeducation programs provide? • Education about mental illness • Improves communication • Improves problem-solving
Cognitive-Behavioral Couple’s Therapy (Monson) • Targets dysfunctional attitudes and beliefs that traumatized people often have about relationships. • Addresses issues about trust, power and control, esteem, safety, and intimacy. • Data show significant reductions in PTSD symptoms as rated by the clinician and partner.
Structured Approach Therapy(Sautter and Glynn) • Combines behavioral couple’s therapy and acceptance-based treatments. • Targets emotional numbing. • Improves dyadic coping with anxiety. • Reduces PTSD symptoms.
