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VA Connecticut Healthcare System

 

Signs of Good PTSD Care

Once treatment starts, you should stay an active player in your care.

Once treatment starts, you should stay an active player in your care.

By Jessica Hamblen, Ph.D.and Cybele Merrick, MA, MS, of the VA National Center for PTSD
Sunday, July 1, 2018

As a veteran with PTSD, you deserve the best treatment available. Whether you are seen at VA, in a Vet Center, or by a community provider, you need to feel sure that your care is working for you.

If you are happy with your care, if your symptoms are getting better and you feel hopeful for the future, then you are all set.  But if you don’t feel like you are making progress or you are not satisfied with your care, you might be wondering what to do next.

Once treatment starts, you should stay an active player in your care.

Let these three signs of quality care guide you. You can refer to them if you are in treatment, especially if you are not happy with your progress or before you begin to work with a provider. They don’t all have to be present for you to know the treatment you are getting is high-quality. But they each will improve your chances of getting the care you deserve.

#1: You’re involved in your care

If you have ever been diagnosed with a medical condition, your provider probably told you your treatment options, and you worked together—perhaps with your family—to decide on the care that was right for you. Why should your mental health care be any different?

In the best case, your provider talks with you about the effective treatments that are available for PTSD—both psychotherapy (talk therapy) and medication (drug therapy). The two of you can then discuss what matters most to you, what your goals are, and which treatments match up with your likes and dislikes.

For example, if you are OK with the idea of talking about your trauma with a therapist, trauma-focused talk therapy would be a good fit. If you know that you’ll forget to take medications on a steady basis, drug therapy might not be the best choice for you.

Once treatment starts, you should stay an active player in your care. Depending on the treatment, that could mean doing some work on your own between appointments, or taking your medication as directed.

#2: You follow a proven treatment

There are a LOT of treatments available for PTSD, but evidence-based treatment has the best chance of working. Evidence-based treatment—both talk therapy and drug therapy—is treatment that has been proven to work for many people in multiple high-quality research studies.

Among evidence-based treatments, one type stands out: trauma-focused psychotherapy. It is the most effective PTSD treatment.

“Trauma-focused” means that the treatment focuses on the memory of the trauma or its meaning. There are different types of trauma-focused psychotherapy. Some names you might hear are Prolonged Exposure, Cognitive Processing Therapy and EMDR. In trauma-focused psychotherapy, you’ll meet with your provider once or twice a week for about 4 months. Treatment is time-limited.

Medication—drug therapy—also treats PTSD well. The evidence-based medications that have been shown to work best are sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), and venlafaxine (Effexor). If you choose medication to treat PTSD, you’ll need to keep taking it for it to keep working.

There are other treatments available. If you are happy with a treatment we have not listed here, there is no need to change it. Sometimes people may choose a treatment that does not have a strong evidence base, and that treatment may be helpful.

But there is one type of treatment that does not help with PTSD symptoms and can in fact be harmful: benzodiazepines—or “benzos.” Some names you may have heard are alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and temazepam (Restoril). Benzos are sometimes prescribed short-term to treat extreme anxiety, panic, or sleep problems.

In the long-term, though, they can be addictive, cause other mental health problems, and make talk therapy less effective. If you are taking benzos for PTSD, work with your provider about making a plan to stop. There are other treatments that are safer and more effective.

         LEARN MORE:

#3 Your progress is measured

Without checking your blood pressure or your weight, how would you know if your high blood pressure (hypertension) treatment or diet was working?  It’s the same with PTSD.

With the best PTSD treatment, your provider will monitor how you are doing. One way to do this is to have you fill out a brief questionnaire to measure your progress from time to time. Your provider will review the results with you, and discuss what they mean for your treatment. If you are not seeing the results you want, you and your provider can talk about other treatment options to try.

       LEARN MORE:

  • VA is using measurement-based care to track patients’ progress and make sure treatment is working.
  • Remember: Quality care for PTSD can take many forms. Seeking out these signs of good care in your PTSD treatment can keep you on the road to feeling better.

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