PTSD and Suicide Ideation in Veterans

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Re: PTSD and Suicide Ideation in Veterans

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Manualized equine-assisted therapy shows promise for treating veterans with PTSD

9/1/21


https://www.news-medical.net/news/20210 ... -PTSD.aspx


As veterans have high rates of posttraumatic stress disorder (PTSD) and historically poor treatment outcomes and high attrition, alternative treatments have gained much popularity despite lack of rigorous research.

For this study published in The Journal of Clinical Psychiatry, a recently developed and manualized 8-session group Equine-Assisted Therapy for PTSD (EAT-PTSD), was tested in an open trial to assess its preliminary feasibility, acceptability, and outcomes for military veterans.

The research was conducted by Yuval Neria, Ph.D., Co-Director/Principal Investigator, Man O' War Project, Columbia University Irving Medical Center; Professor of Medical Psychology Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center; Director, PTSD Research Program, Director, New York Presbyterian Military Family Wellness Center at New York State Psychiatric Institute and Prudence W. Fisher, Ph.D., Co-Director/Principal Investigator, Man O' War Project; Columbia University Irving Medical Center; Associate Professor of Clinical Psychiatric Social Work (in Psychiatry) Columbia University, Vagelos College of Physicians and Surgeons; Research Scientist at New York State Psychiatric Institute.

The study found that manualized EAT-PTSD shows promise as a potential new intervention for veterans with PTSD. It appears safe, feasible, and clinically viable. These preliminary results encourage examination of EAT-PTSD in larger, randomized controlled trials.

The study was conducted from July 2016 to July 2019. Sixty-three treatment-seeking veterans with PTSD enrolled. PTSD diagnosis was ascertained using the Structured Clinical Interview for DSM-5, Research Version (SCID-5-RV) and confirmed using the Clinician-Administered PTSD Scale (CAPS-5). Mean age was 50 years, and 23 patients (37%) were women. Clinician and self-report measures of PTSD and depression were assessed at pretreatment, mid-treatment, and post treatment and at a 3-month follow-up. An intent-to-treat analysis and a secondary analysis of those who completed all 4 clinical assessments were utilized.

Thirty-two patients (50.8%) showed clinically significant change (≥30% decrease in CAPS-5 score) at post treatment and 34 (54.0%) at follow-up. Post treatment assessment revealed marked reductions in both clinician-rated and self-reported PTSD and depression symptoms, which persisted at 3-month follow-up. Specifically, mean (SD) CAPS-5 scores fell from 38.6 (8.1) to 26.9 (12.4) at termination. ​ Only 5 patients (8%) withdrew from treatment, 4 before mid-treatment and 1 afterward.

Background


The Man O' War Project at Columbia University Irving Medical Center is the first university-led research study to explore the use of and scientifically evaluate equine-assisted psychotherapy in treating veterans with PTSD, which includes developing a well specified treatment manual – the first of its kind -- which will be made available to the field.

The project began in 2015 with funding from philanthropist Ambassador Earle I. Mack, a veteran himself, and longtime thoroughbred owner/breeder, who was concerned about the mental health crisis facing veterans and his observation of anecdotal stories from various equine-assisted therapy groups, with no hard science to support their claims. Ambassador Mack approached David Shaffer, MD, former director of the Division of Child and Adolescent Psychiatry at the Columbia University/ New York State Psychiatric Institute and soon a team was formed, led by Dr. Prudence Fisher and Dr. Yuval Neria.

Source:

Man O’War Project https://mowproject.org/

Journal reference:


Fisher, P. W., et al. (2021) Equine-Assisted Therapy for Posttraumatic Stress Disorder Among Military Veterans: An Open Trial. Journal of Clinical Psychiatry. doi.org/10.4088/JCP.21m14005.
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Re: PTSD and Suicide Ideation in Veterans

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Veterans behind Vegas-area nonprofit helping others with PTSD through gaming

9/1/21


https://www.ktnv.com/news/vegas-stronge ... -with-ptsd


By: Rachel Moore
Posted at 12:52 AM, Sep 01, 2021
and last updated 8:49 AM, Sep 01, 2021

LAS VEGAS (KTNV) — A group of Army veterans is calling on other veterans to join their squad.

Dad Body Calvary is a nonprofit that collects and rebuilds gaming consoles and computers to donate to other veterans who may be feeling lost after separation from the military.

“When you get out of the military, and you’ve been in there for a long time, you have this identity that you know what your purpose is. You know what you’re worth, you know what you’re doing and then when you transition into civilian life you kind of lose that,” said Christopher King.

The team operates Call of Duty soldiers -- they are real soldiers after having served in the 3rd Infantry Division. Together, they were deployed to Afghanistan in 2005. Two years ago, they reunited to form Dad Body Calvary.

“It’s the competition aspect of it, the social aspect of it, the teamwork aspect of it,” Said Jeff Briner. “It all goes back to our military service and how we all worked together.”

All of the members are dads, and they can admit that they’ve packed on a few pounds since leaving the military, but besides their friendship, the one thing that has remained the same is their commitment and duty to serving others.

“We’ve found something that we’ve missed, not even the past two years but over the past several years,” said Brad Rollings. “We’re trying to offer that to as many other veterans as we can through our community.”

Gaming is a sort of therapy for the DBC. Many veterans struggle with transitioning back into civilian life as well as post-traumatic stress.

“There’s always constant thoughts, there are always memories, there’s always stuff that just out of nowhere hits you,” said Daniel Meservey. “There are triggers out there and gaming kind of puts those triggers away and I can just focus on hanging out with my brothers and sisters. Playing the game helps me shut off for a while.”

Dad Body Calvary is searching for veterans who might need an outlet or a network of veterans. DBC says its accepting nominations for veterans who would be interested in gaming. They are also raising money to purchase and restore computer equipment.
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Re: PTSD and Suicide Ideation in Veterans

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Equine Therapy: Horses Help Veterans Struggling With PTSD

9/1/21


https://www.usnews.com/news/health-news ... -with-ptsd


WEDNESDAY, Sept. 1, 2021 (HealthDay News) -- As a Marine Corps veteran who served in both Iraq and Afghanistan, Matthew Ryba understands what life in a combat zone can do to soldiers' minds, leaving many struggling with post-traumatic stress disorder.

Now, new research shows that equine therapy might go a long way in starting the healing process for these veterans. In the program, participants learned about horses, stroking their sides, cleaning hooves and building trust with the animals.

"We saw with the study that a lot of people who were not amenable to going into traditional therapy because they had an idea of what mental health therapy was because they had this kind of ingrained, sense of, 'I don't need help. I'm a military service member. I'm stronger than this kind of a thing,'" said Ryba, who is now director of community outreach and education for the Military Family Wellness Center at New York Presbyterian/Columbia University Medical Center in New York City.

"When they realized that, I don't want to call it a dependent relationship with the horse, but kind of as equals with the emotional balance with the horse, they realized that, 'maybe I do need some help,'" he said. "It was a good stepping stone into a traditional therapy."

The U.S. withdrawal from Afghanistan and the attack that caused the death of dozens of people, including 13 members of the U.S. military last week, is dredging up a lot of memories for veterans, Ryba noted.

"We're at a very pivotal moment where programs like this ... and the other military support programs for veterans are of the utmost importance," Ryba said. "We see the suicide rate continuing to rise. These problems are getting worse and not better, and we really need the support from the public and from others to be able to fund this kind of research so that we can find tools to be able to help veterans that need it."

The new study assessed the equine therapy program known as the Man O' War project for veterans at the Bergen Equestrian Center in northeastern New Jersey.

Study authors Prudence Fisher, a research scientist at New York State Psychiatric Institute, and Yuval Neria, professor of medical psychology at Columbia University Medical Center, founded the equine therapy project. Ryba helped recruit vets for the fledgling program.

Easing of symptoms

"We were totally open to it not working," Fisher said.

The study was conducted from July 2016 to July 2019, enrolling 63 veterans who had PTSD. They were men and women with a wide range in ages. Their PTSD was assessed by a clinician and through self-reporting before they started the program, mid-treatment, after treatment and three months later.

Researchers grouped the participants into teams of typically four veterans plus two horses, a mental health professional, an equine expert and a third staff person, to be another set of eyes.

The participants received eight weeks of weekly 90-minute sessions with the horses, where they might talk about their PTSD, but didn't speak specifically about their traumas.

In addition to recording and assessing the process, the researchers worked with manual writers to create a detailed book of the therapy protocol, to help guide other programs in the future.

The researchers found that equine-assisted therapy (EAT) showed real promise.

"Our study would say, it could work, but what we looked at is, does a specific type work? We're not speaking for equine-assisted therapy as the whole field," Fisher said. "But I think it is a good indication that it does work, that there is something about it that can be really, really helpful."

The veterans had marked improvement in PTSD symptoms and in depression after the treatment ended, and that persisted even three months later.


Stepping stone to more therapy?

Though training has already begun to help other programs try this type of project, it may not be a good fit for all equine-based programs, Fisher said. Having a mental health professional on the team is critical for certain mental health conditions, she said.

"PTSD is a serious illness. People can get worse. My own personal opinion is if you go to a program and think you're getting treatment, then you might not be going to [other] treatment that might help you," Fisher said. "So, it's really important that you have somebody who keeps an eye on what's going on and knows if you're getting worse or you're getting better."

The program is a gentle introduction to therapy, with opportunities for participants to ground themselves, help each other, and learn about communication and self-regulation, Fisher added.

The study was an open trial, which makes it harder to say the changes the participants experienced were specifically because of the horses. A randomized, controlled trial with different types of treatments, would be more definitive. The findings were published Aug. 31 in the Journal of Clinical Psychiatry.

The study results are encouraging, said Dr. Stephen Stern, a psychiatrist and adjunct professor in the Department of Psychiatry and Behavioral Sciences at the University of Texas Health Science Center at San Antonio. It's also important to be careful about how to interpret it, he added.

Both the staff and the participants were likely enthusiastic, which can have an effect on people's symptoms, said Stern, who wasn't part of the research. The study also included a lot of human interaction with veterans in small groups and study staff, alleviating some of the loneliness experienced by those with PTSD.

"I think the paper itself was really very good and they didn't hype their results at all, but I think it's important that the public not overinterpret this," Stern said. "Yes, this is encouraging, but we don't know to what extent this therapy actually had an effect and we need to study it further."
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Re: PTSD and Suicide Ideation in Veterans

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Ft. Carson veterans create Objective Zero, a mobile app to prevent veteran suicide

9/2/21


https://www.koaa.com/community/you-are- ... an-suicide


By: Ashley Portillo
Posted at 6:17 PM, Sep 01, 2021
and last updated 11:38 AM, Sep 02, 2021

EL PASO CO. — Now that the United States has fully withdrawn troops from Afghanistan, more active duty military and veterans are reaching out for help. One app that offers mental health services was created by two Fort Carson veterans. The app is called "Objective Zero," and was created by the veterans based on their own personal experience.

Justin Miller, one of the co-founders and story teller for the organization, recalls a day in July 2015 around 4 o'clock in the morning, when we was struggling mentally after returning home from the military.

"I just started falling apart. I was sitting on the edge of my bed with a pistol in my hand, and I was ready to quit," said Miller, an 11-year U.S. Army Veteran.

Miller then gave Chris Mercado a call, who's also a U.S. Army Veteran and was stationed at Fort Carson with Miller.

"When I was on that call, I asked him what he was going through and how he's feeling. I just sat there and listened without judging him or trying to solve all of his problems, and I was worried," said Mercado, who served in army for 23 years and is the operations director and co-founder for the organization. "I'm not a trained therapist or counselor, but all I could do was offer a listening ear and be a sympathetic friend."

"We talked on the phone about why I joined, and he gave me a different perspective on how life was going," said Miller.

The six-hour long phone call between the two veterans saved Miller's life and is the inspiration behind Objective Zero.

The 501C3 non-profit is "using technology to combat suicide in our military community among our active duty service members, reserves, national guardsman, and our veterans," said Mercado.

Objective Zero is a free app anyone can download on their phone. It connects users to a nationwide support group and mental health resources.

"We're accomplishing that by connecting them to 24/7 peer support through voice, video or text message," said Mercado.

Users can pick up the phone at any time of the day and get help and talk to a veteran on the other end, just like Miller did.

"During that conversation, I was in such a bad spot that all I cared abut was making it through the night, and I didn't believe I had a story," said Miller.

However, Miller's story has helped so many others, including the nearly 10,000 app users last year.

"That's when it really set in like wow, we have survived now going on five years, and saving lives," said Miller. "The app is being used every single day and that's when I realized talking to somebody really can save lives. Why not have this in every soldier's or service member's phone?"

The main goal of Objective Zero is helping prevent the nearly 20 suicides among veterans each day, and letting them know, they are not alone.

"We need to as a nation come together and do this because, if we don't come together as a nation, we're never going to solve this problem," said Miller.

"Just be there, and be willing to listen, and sometimes that's all it takes to make a difference in somebody's life," said Mercado.

The founders also said they've seen a 254% increase in users accessing the app in the past month. There's also been an 83% increase with users accessing activities, training and inspirational quotes within the app; a 776% increase in users connecting to the veterans crisis hot line through the app, a 132% increase in users reaching out to be trained in crisis prevention, and an 85% increase in text messages being sent.

If you'd like to help, you can also get trained on crisis prevention, and have life-changing conversations with service members across the country.

Another way of helping is encouraging and veterans or active duty military you know, to download the app and have it as a resource on their phone whenever they need it.

For more information about Objective Zero, click here :

https://www.objectivezero.org/
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Re: PTSD and Suicide Ideation in Veterans

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Texans with PTSD or cancer can now use medical marijuana under new law
The new law that took effect today also doubled the amount of THC allowed in medical marijuana to 1%.

9/1/21

https://www.khou.com/article/news/healt ... 259a80c0ca


AUSTIN, Texas — A new Texas law allows people with PTSD or cancer at any stage to use medical marijuana. Under The Texas Compassionate Use Program they can use “low-THC cannabis.”

Until today, the medical marijuana law applied to fewer than 6,000 Texans with terminal cancer and some neurological disorders, including Alzheimer's and Parkinson's disease. An estimated 114,000 Texans who have cancer are now eligible, along with veterans diagnosed with post-traumatic stress syndrome.

The new law also doubles the percent of THC -- the part of marijuana plants that can cause the sensation of being high or happy -- allowed in products to 1%.

For cancer patients, THC can alleviate the side effects of chemotherapy, such as nausea, loss of appetite and body pains.

Barbara Bevill of Wylie was diagnosed with breast cancer in 2014 when 11 tumors were found on her left breast. She endured 18 months of chemotherapy, 33 rounds of radiation and a major invasive surgery.

Bevill consumed marijuana throughout her fight with cancer, which she said helped her maintain her appetite and hold on to hope. But since it was illegal, she almost always got ahold of marijuana through friends.

“It was something illegal, something I couldn’t access,” Bevill said. “I would have loved to have known the percentages and everything that was in it… but it was not like I could go to a dispensary or store to ask. I took what people gave me.”

THC can also help calm PTSD patients and decrease their nightmares, according to Dr. Muhammad Assad, a psychiatry fellow at Texas Tech University’s Health Sciences Center.

“Because they’re coming from a traumatic situation, they get very vigilant, they get very aroused, they’re always ready for challenges. So the medical marijuana calms them down," Dr. Assad explained.

David Bass came home to Fort Worth in 2006 after serving in the Army but sometimes he feels like he’s still in Iraq. The 64-year-old Desert Storm veteran who served 25 years in the military has nightmares that he's back in Iraq and under attack.

“I can hear Iraq, I can smell Iraq. I can hear the rockets going off," Bass told the Texas Tribune.

He was prescribed several kinds of medications to ease his hypervigilance after being diagnosed with post-traumatic stress disorder. But those medications didn’t help him sleep. Instead, they caused him to have “flat emotions” — and, eventually, suicidal thoughts.

He said marijuana helps "organize his thoughts" and bring him "down to earth but he had to get it illegally for years.

Now eligible Texans including Bass and Bevil, can get it legally in capsule form, edibles or oils. Smoking it is still banned.

Texas is one of 36 states that allow the use of medical marijuana, according to the National Conference of State Legislatures.
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Re: PTSD and Suicide Ideation in Veterans

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The aftermath of war
Addressing mental health issues caused by a drawdown of forces

9/1/21


https://militaryfamilies.com/military-d ... th-of-war/


When the end of Army veteran James Davis’ deployment to Afghanistan was in sight, his excitement about returning home in time for his son’s birthday suddenly was replaced by a “knot in the gut” created by a simple question: Why had he survived when others had not?

“I got to go home because somebody else had to come and take my place,” recalled Davis, a retired lieutenant colonel from Horry County, South Carolina. “That person may not be as fortunate as me. I’ve asked the question often, as many of us do, ‘God, what’s so special about me that I get to live?’”

As the United States removes its forces from Afghanistan and marks the end of the nation’s longest military engagement, survivor’s guilt is but one of the mental health challenges facing some of the nation’s post-9/11 veterans, more than 2.7 million of whom deployed to a war zone during the past 20 years.

Epidemiologist Rajeev Ramchand, PhD, a senior behavioral scientist at RAND Corporation, notes that veterans’ mental health issues can span a range of diagnosable conditions such as post-traumatic stress disorder, depression, traumatic brain injury, anxiety, and substance abuse. But most are “treatable conditions,” Ramchand pointed out. “So, there’s hope. There are evidence-based treatments that we know work.”

Clinical counselor Duane France, LPC, an Army retiree, says service members reintegrating into civilian society can also be impacted by “transition stress” caused by worries related to basic necessities, such as jobs, housing, and loss of a sense of purpose.

“I work with a lot of veterans who feel like they want to have more purpose and meaning in their post-military lives,” said France, director of veteran services, Family Care Center, Colorado Springs. “They want to be satisfied with what they’re doing, and they feel a loss of that after the military.” 

Integrating back into family life can be challenging for service members who have spent their military careers on endless deployment cycles. Because families adapt to repeated separations by creating new roles within the family, Ramchand said returning military members may not “know where they fit in this new system or they may want to go back to the old system and the family doesn’t want to.” 

Ramchand says an “open dialogue and trusting in that communication” is key to solving reintegration challenges. He also suggests couples take advantage of military marriage enrichment programs and seek counseling as needed.

Give an Hour is one place to turn for help. The national nonprofit includes 4,200 licensed mental health providers who each week offer free and confidential counseling to active duty, veterans, members of the Guard and reserves, and their family members.  

Give an Hour Chief Executive Officer Trina Clayeux, PhD, stresses the importance of military members crafting a support system and, when necessary, seeking mental health help from within their communities, military bases, or from licensed professionals.

‘It’s really trying to find what fits for you,” she said.

Clayeux also suggests not waiting for a crisis to seek help.

“Support can come at any place in your mental health and wellness journey,” she said. “It doesn’t have to wait until it gets significant so that it’s impairing parts of your life. Sometimes we just need support in real time for a particular event and other times we need support that’s more long term and reoccurring.”

While the outward signs of a mental health problem can be highly individualized, France says a person experiencing a mental health crisis often has a “change in normal behavior.” That could mean a gregarious person becomes withdrawn or vice versa, a change that may be accompanied by increased use of coping techniques such as drugs or alcohol. Service members may also have “anniversary reactions” tied to traumatic events that occurred while they were deployed. 

“Memorial Day doesn’t just happen in May for a lot of veterans,” France said. 

Davis adds that not every veteran is able to compartmentalize their time in Iraq or Afghanistan and leave the war “over there.” Officers may not be “kicking in doors and squeezing bullets directly at the bad guy,” he said, but they too can experience trauma from decisions made in wartime.

“We orchestrate it all,” Davis said. “So, when we put something together that results in a life being taken, we share in that responsibility. We live with that, too.” 

Since retiring from the military in 2011, Davis has taught Junior ROTC and served as Director of Military & Integrated Services for Horry County Schools. Through counseling, he has learned to open up about his wartime experiences and draw strength from the memories of friends lost to war. 

“We need to talk and express those feelings,” he said. “We need to open up and be able to move forward with our life. That part of our life is over. It’s completed and not continuing to haunt us every day.” 

Where to turn for help:


Coaching into Care https://www.mirecc.va.gov/coaching/

Give an Hour https://giveanhour.org/military/

Military OneSource: Building Health Relationships https://www.militaryonesource.mil/confi ... tionships/

State Veterans Benefit Finder https://www.cnas.org/publications/repor ... fit-finder

Army Strong Bonds Program https://www.strongbonds.org/

Marine Corps Prevention and Relationship Enhancement Program (PREP) https://www.quantico.usmc-mccs.org/mari ... gram-prep/

Navy Chaplains Religious Enrichment Development Operations (CREDO) https://www.cnic.navy.mil/regions/cnrma ... grams.html

Air Force Marriage Care Program 

Real Warriors Campaign https://www.health.mil/Military-Health- ... s-Campaign
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Re: PTSD and Suicide Ideation in Veterans

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Combat veterans with PTSD use motorcycles, woodworking to cope

Program uses artistic techniques to provide a safe outlet to work through trauma

Sept. 2, 2021 4:18 PM PT


https://www.sandiegouniontribune.com/co ... e-ptsd-art


By Tammy MurgaReporter

Two weeks ago, U.S. Navy veteran Julian Ospina received a 2 a.m. phone call from another veteran who was having a hard night and really needed company.

“We jumped on our (motorcycles),” he said, and “drove straight to Anaheim Stadium. He did two laps around the stadium, pulled into an AM PM (minimart). He got a cup of coffee and I got hot chocolate and he goes, ‘Can we go home now?’ That’s all he needed.”

The veteran who called him is one of several who participate in Ospina’s recreational therapy program where he guides combat veterans in restoring their own Harley Davidson motorcycles. He also manages a woodworking workshop at the Veterans Home of Chula Vista, both programs serving as artistic ways for veterans to cope with post-traumatic stress disorder.

PTSD often appears after exposure to trauma, which can include combat, sexual assault, criminal victimization, a natural disaster, or a car crash. Symptoms can include recurrent nightmares, flashbacks, having outbursts of anger and feeling emotionally numb, according to the University of California, San Diego’s School of Medicine.

On Friday at the Bonita Museum and Cultural Center, he will lead a public conversation about PTSD and how individuals can find creative ways to cope.

“For many, it’s not easy to open up, especially with somebody who doesn’t understand where you’re coming from,” Ospina said. “What I reiterate in the programs is that you are your best doctor because you know what your problem is.”

Ospina is a retired paramedic who served in Iraq and Afghanistan and has used his degrees in psychiatric rehabilitation to guide his programs. He also volunteered at the Sharp South Bay Vaccination Super Station, where he met thousands of people who received the vaccine and helped ease their nerves, he said.

“Not everybody wants to do woodworking, not everybody wants to do motorcycles. Maybe you want to do underwater basket weaving. Maybe that’s what might help. Anything can help and that’s why you see so many different ways, like horseback riding, parachuting, anything,” he added.

For La Jolla resident Joseph Frangiosa, a retired Navy and Marine Corps veteran who also served in Afghanistan, building handmade model ships is his outlet. Upon returning from deployments over the course of two decades in the military, he would often build and repair detailed miniature pieces for hours, eventually creating collections from different historical periods, ranging from the Civil War to World War II, he said.

His creations make up the small but intriguing Nautical History Gallery & Museum on Pearl Street in La Jolla. The Bonita Museum temporarily offered him a larger space to display his work, now available for viewing through Sept. 18 for his exhibit “Permission to Come Aboard: The History of Navy Ship Design.”

Attendees on Friday will have a chance to hear from Ospina and view Frangiosa’s creations.

The conversation is open to anyone interested in learning more about PTSD, regardless of one’s background, whether a veteran or medical professional, Ospina said.

The event is free and scheduled to run from 3 to 5 p.m. at the museum, located at 4355 Bonita Rd. To register, visit here.
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Re: PTSD and Suicide Ideation in Veterans

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Veterans Struggle With Issues That Are Often Invisible to Others

9/11/21


https://www.nytimes.com/2021/09/07/us/p ... erans.html
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Re: PTSD and Suicide Ideation in Veterans

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Veteran services saying ‘purpose’ could be key in suicide crisis
Community

National Suicide Prevention and Awareness Week began Monday


https://www.rochesterfirst.com/news/vet ... de-crisis/

by: Christian Garzone
Posted: Sep 6, 2021 / 08:00 PM EDT / Updated: Sep 7, 2021 / 07:22 AM EDT


ROCHESTER, N.Y. (WROC) — September 5 kicks off National Suicide Prevention and Awareness Week, and one community that deals with that topic on a daily basis is our nation’s veterans. In the US, we lose around 22 each day to suicide. News 8 spoke with Veteran Services at the County, and the Veterans Outreach Center, to see what the underlying causes may be — and what solutions exist.

Traditionally, Nick Stefanovic with veteran services says Veterans Affairs is the ‘go-to’ for mental health treatment.

“Know that the VA is limited in their capacity and we can do more,” he says.

Stefanovic says thankfully we have a number of additional resources here like the Veterans Outreach Center. Giving a veteran ‘purpose’ he says is key.

“When you get out of the military, many of us, we can’t find our way towards having that purpose again. Having that purpose in life removed can be crushing to somebody. So the answer is opportunity. We have to go beyond sitting down with veterans in an office and talking about their feelings. We have to be willing to work through and be willing to present opportunities to them. Opportunities for jobs, opportunities for meaning in their lives,” he says.

Laura Stradley with the VOC says purpose is a big part of the solution. “I think providing purpose is hugely important though and that’s one of the things you hear veterans say most often,” she says.

It’s something the VOC does every day through therapy programs and employment opportunities, but that said, “It’s so complicated and it’s so unique to every individual,” Stradley adds.

She says that’s why it’s so hard to get a grip on why so many veterans take their lives. Recent events like the Afghanistan exit she says also prompting mixed emotions. The national crisis line in Canandaigua seeing a spike in calls when compared to last year, the pullout is likely the cause she says.

Compared with this time last year, calls are up 7%, texts are up 95%, and chats are up almost 40%, according to numbers provided by the Canandaigua VA.

“I think how many of them are feel their service and sacrifices were almost futile,” she says.

Stefanovic says when it comes to mental health, Congress needs to do more to let the VA outsource into local communities.

“The federal government needs to be able to push money into the hands of local community providers,” he says.

For Suicide Prevention and Awareness Week, the VOC has a series of events planned, including ‘crisis in a crisis workshop’, ‘raise the flag’, and others.

For full details, click here :

https://veteransoutreachcenter.org/suic ... ntion-week
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Re: PTSD and Suicide Ideation in Veterans

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MDMA-assisted couples therapy may help maximize recovery among patients with PTSD

9/7/21

https://www.psypost.org/2021/09/mdma-as ... ptsd-61826


A study published in Frontiers in Psychiatry lends support for a relationship-based approach to the treatment of post-traumatic stress disorder (PTSD). The researchers tested the efficacy of Cognitive Behavioral Conjoint Therapy, a couples therapy tailored to patients with PTSD and their partners. The intervention, which included two MDMA-assisted sessions, led to gains in both patient growth and relationship growth.

Post-traumatic stress disorder is a psychological condition that can emerge after experiencing or witnessing trauma. Patients often relive the traumatic event through nightmares or flashbacks that provoke debilitating fear, panic, and anxiety. Psychologists have noted that a key factor influencing both the development of PTSD and recovery from the disorder is a patient’s close relationships.

While negative social interactions can aggravate PTSD symptoms, PTSD symptoms can also cause strain on interpersonal relationships. This leads to a self-perpetuating cycle whereby a patient’s symptoms continually worsen. For this reason, study authors Anne C. Wagner and her colleagues emphasize the advantages of a dyadic approach to treatment — that is, therapy efforts that include both the PTSD patient and their partner.

The researchers designed a study to explore the effectiveness of Cognitive Behavioral Conjoint Therapy (CBCT) in the treatment of PTSD. Six patients with PTSD, along with their partners, took part in the 7-week therapy which involved 15 CBCT sessions. The CBCT sessions included psychoeducation about PTSD, strategies for increasing communication and reducing avoidance, and tools for coping with trauma-related thoughts.

The intervention also included two MDMA-assisted sessions following the fifth and eleventh CBCT sessions. MDMA, or 3-4 methylenedioxymethamphetamine, is a psychoactive drug commonly referred to as ecstasy that is known to facilitate empathy and partner communication. During these sessions, both partners were given MDMA and then listened to relaxing music while alternating between internal reflection and conversing with their partner.

Participants were assessed on five occasions throughout the study: at baseline, halfway through treatment, post-treatment, three months following treatment, and six months following treatment. The assessments included various questionnaires that measured relationship quality, psychosocial functioning, patient’s post-traumatic growth, and partner’s response to trauma.

According to both partner and patient reports, the PTSD patients showed improvements in post-traumatic growth throughout the therapy. Patients additionally showed lower psychological aggression, improved psychosocial functioning, and increased empathy. Notably, partners also benefited from the therapy. They decreased the extent that they accommodated their behavior in response to the patient’s PTSD symptoms — a behavior that can unintentionally reinforce PTSD symptoms.

Importantly, the couples also experienced relationship gains — both partners and patients reported increased intimacy and increased relational support. Partners additionally reported that conflict had improved within the relationship.

Moreover, these positive outcomes were maintained during the follow-up period. The researchers say their overall findings suggest that CBCT combined with MDMA sessions can lead to improvements among both patients with PTSD and their partners. “By targeting individual and relational functioning simultaneously,” the authors write, “this intervention has the potential to maximize recovery from trauma and enhance present living for those with PTSD and their loved ones.”

However, the study was not without limitations, such as a small and nonrepresentative sample. Wagner and her colleagues propose that their findings call for a larger, controlled study among a more diverse sample.

The study, “Relational and Growth Outcomes Following Couples Therapy With MDMA for PTSD”, was authored by Anne C. Wagner, Rachel E. Liebman, Ann T. Mithoefer, Michael C. Mithoefer, and Candice M. Monson.
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