Why do we Need to Support Veterans?

The Veteran population is seen experiences a wide range of issues after coming out of the military. Some issues Veterans faces are coping with post-traumatic stress disorder, disability, homelessness, unemployment, addiction, and suicide (Schlenger et al., 2002). A traumatic event causes physical, emotional, and psychological harm (Schlenger et al., 2002).

Rothbaum, Rizzo, and Difede (2010) state that "Posttraumatic stress disorder (PTSD) is a chronic, debilitating, psychological condition that occurs in a subset of individuals who experience or witness life-threatening traumatic events. People in the military are among the most at-risk populations for exposure to traumatic events resulting in having posttraumatic stress disorder after serving the military (PTSD; Prigerson, Maciejewski, & Rosenheck, 2001; Schlenger et al., 2002). Post-Traumatic Stress Disorder is classified as an anxiety disorder related to a threating event (Ehlers and Clark, 1999, p. 320).

Research has stated that there are more veterans with high levels of PTSD and unrelated mental symptoms after serving in Iraq and Afghanistan (Hoge, Auchterlonie, & Milliken, 2006; Hoge et al., 2004). It is essential to identify the issue and work with effective treatments to assist the military population. The issues veterans face is complicated and requires support from the government, community and Veteran Affairs (VA). Leaving a type of situation to be left untreated it may cause serious mental problems down the line that may be harder to resolve.

Some of these veterans have been exposed to unmoral situations that need significant attention, resources, and skills in transitioning back to their normal life. It is a significant transition. After the military, it is essential to engage with the VA to get the resources and support necessary. Those impacted by these issues cross all socioeconomic boundaries, cultures, and ages edit this . People from all over the U.S. primarily people age 18 and up to join the military. It started off as a human-made job, but after time many more women entered the army. However men take up more of the veteran population. These negative impacts pushed the VA to provide individual counseling, pieces of training and programs to assist all types of trauma experienced. It is an overwhelming experience that requires amounts of exposure, support, and talk therapy. This type of injury on this population has caused a significant strain on the systems in place and for these systems to change direction.

There are about 21.8 million veterans in the United States (VA.gov, 2017). About 578,500 veterans experience homelessness on any given night due to experiencing trauma (HFAL.org., 2016). The rate of Veterans who are unemployed is higher than the national average in many states (Military Times, 2017). Between July 1, 2014, and June 30, 2015, a total of 738,212 of these Veterans accessed the VA health care, with a considerable increase 78% throughout 2001-2016 (VA.gov, 2018). Therefore it has shown the prevalence of veteran issues requiring a change in the resources and programs available to help assist these veterans with the appropriate therapeutic intervention. This paper will help address the problems the veterans have faced, and the technique used by the mental health department by utilizing the evidenced-based practice of Cognitive Processing Therapy (CPT). CPT has shown to be more active on individual setting compared to group settings. CPT is also another form in replacement of medication that has been shown to be effective. Veterans require a long-term treatment when dealing with the exposure of challenging situations such as war. The focus should be on helping the veterans since they work their best at protecting our country. If left untreated there would be countless veterans suffering to get back to work and family. It may also cause innumerable amounts of money to keep these veterans off the streets, jail, and addiction due to the direction they would take if they did not have the appropriate resources when coping with a trauma.

Section Two

Evidence-based interventions (EBI) are treatments which have been proved to be effective in accessing the situation, changing the behavior and thought processing (Curley & Vitale, 2016). These interventions are tested to be valid and reliable through observational studies and clinical trials. CPT is a type an EBI, which focuses on trauma-focused evidence-based intervention utilized for all kinds of populations who have experienced various forms of trauma such as the individuals that have been active in the military (Chard, et al., 2012). Originally, CPT was developed as a treatment for grouped psychotherapy. However many clinicians saw the more significant impact it made on their clients (Chard et al., 2012). CPT teaches how to evaluate and change the upsetting thoughts since the trauma, by changing the thoughts and perceptions on the way you feel and think. Injury can change the way you feel about yourself and the world (Epdf.tips, n.d.). CPT is a type of intervention that is used to in to recognize and challenge one's experience about the traumatic event they have experienced. CPT uses techniques to help the person in "labeling events, accessing thoughts and emotions, while the clinician helps them identify the issue and question their thinking " (Resick et al., 2017).

In a study conducted by Resick, et al. (2017), a group of 8-10 military veterans participated in receiving CPT. The study compared the CPT skills applied in a group setting compared to an individual environment. The group met for ninety minutes, twice weekly, for six weeks, while the individuals met for ninety minutes, twice weekly, with a clinician. The results indicated that CPT was more active and showed improvement on those who were in treatment individually with a clinician compared to those who were in a group setting. At the beginning of the intervention, individuals are educated regarding the purpose of CPT treatment. It is essential to let the individual know how his type of therapy will help them for them to show commitment and involvement in the process. The individuals are asked to write down traumatic events they have seen, and the impact these events have caused. Being open and being an observer of this trauma can help them distinguish their perception and thoughts it has made. This helps the individual in exploring their beliefs, opinions, behavior about the traumatic events, and how it has shifted their perception on their life (Chard et al., 2012). This type of trauma needs a step-by-step process. Being in a group setting may cause judgment, anxiety and not enough exposure to one's trauma when having others be involved compared to those who process this individually without the distractions of others.

Other reasons group setting are not primarily as useful is because of the content exposed, not enough support, and if they miss a group, they may lose a big piece of processing. In an individual setting, participants received particular attention regarding multiple traumatic events they have experienced resulting in a more significant improvement (Resick et al., 2017). However, in the group setting CPT showed improvement after six months of individual treatment then the group setting could be introduced. It showed that after the person went through individual counseling, then they could go on to the step of group counseling. Once the person is at a better state, then they can be part of group therapy to process it by hearing other people struggle and practice different skills in groups to help assist these PTSD symptoms for long-term practice. Even though this is a general standard of months, every person processes this type of trauma differently and might vary. Monson et al. (2006) stated that CPT treatment for veterans with PTSD has shown to be effective in its ability to assist the individual in addressing violent acts they have committed, witnessed, or experienced (Monson et al., 2006).

This type of treatment has also shown a considerable amount of improvement on disorders such as anxiety, depression, guilt, stress, and social adjustment that these personal military experience (Monson et al., 2006). The US Department of Veterans (USDVA) stated that CPT is the most successful treatment of counseling for the PTSD issues of veterans with a success rate of 75% (USDVA, 2015). It helps people turn the negative thoughts and memories into positive ones. The VA throughout the years has advocated in changing prior systems to increase the use of CPT to treat PTSD amongst people who serve in the military.

Section Three

Veterans benefit the most from CPT due to the harmful exposure of the military in their lives. Therefore, The VA has mandated people who have experienced this type of trauma be offered CPT," (Morland, Hynes, Mackintosh, Resick, and Chard, 2011, p.465). CPT has been shown to be the practice model in the International Society for Traumatic Stress Studies Practice Guideline, and the Veterans Health Administration Department of Defense Clinical Practice Guideline (Keane, Friedman, & Cohen, 2008). The VA has practiced ensuring all Veterans have access to CPT at their local hospital or community clinic," (Chard, Schumm Owens, and Cottingham, 2010, p. 27). Applying this intervention to veterans requires step-by-step action. Starting with identifying the trauma and visualizing the effects it has made on the person. Shifting one's thought process such as violence, shame, and guilt to thought processes of acceptance, commitment and changing the way you think of these effects is a way to replace negative thoughts. After identifying these traumas then the shift of patterns can take effect.

Being in a group setting could help veterans see they may have similar experiences and are not alone in their thought process. These veterans may have been in the same area when an event occurred, but they all process the trauma differently and experience it differently as well. Group CPT sessions can provide a safe and compassionate network for the member to handle the events and give them a sense of security, free from judgment and space to discuss their feelings. Writing down the feelings being experienced may be difficult, but it may also help when coping with painful emotions such as anger, sadness, and guilt. This type of process can help any areas this trauma has been affected by changing the sense of safety, trust, control, self-esteem, and intimacy. This type of intervention can be placed in any cCommunitysSchool ormental health facilities of people who have any PTSD.

One drawback to CPT with veterans is the feeling and psychological pain it may cause by reliving their trauma. Bringing the wound to the surface may cause an uncomfortable feeling. This can create a difficult time and could develop new injuries to surface. This is to distinguish the trauma, see their coping mechanism and process their trauma by shifting their thought processes of the shock. Another drawback is some people in the military cannot open up to their locations; they cannot speak about individual events to not put others at risk. This surfaces the person not to want to open up because they are afraid they may be placed in jail. Some of these veterans it may take time for them to shift their perception. For some people, therapy and CBT might not be the best practice for them. They may need more than CPT. In this case, introducing medication in combination can help the veteran from any horrific flashbacks, nightmares, stress, or anxiety. CPT takes time and practice. These types of victims need much more attention than a just therapy itself. Medication is not the only route, but at times it has been shown effective for people who are reliving their trauma for them to not go on a downhill path.

Many individuals and a specified group could benefit from practicing CPT. The shifting of perception, memories, and effects this trauma brings can help you organize your thought process once again to live a happier sustained life. It is possible through practice. The individual has to show commitment to change and be aware that it may feel uncomfortable. The surrounding basis is to take a memory that causes stress or trauma and work through it to get to the point that it does not create these issues any longer. CPT helps veterans and active military members, in assisting them to have a positive effect in dealing with the trauma they have suffered.

References

1. Chard, K. M., Ricksecker, E. G., Healy, E. T., Karlin, B. E., & Resick, P. A., (2012). Dissemination and experience with cognitive processing therapy. Journal of Rehabilitation Research and Development, 49(5), 667-78. Retrieved from https://libproxy.usc.edu/login?url=https://search-proquest-com.libproxy2.usc.edu/docview/1034971962?accountid=14749
2. Chard, K.M., Schumm, J.A., Owens, G.P., Cottingham, S.M. (2010). A Comparison of OEF and OIF Veterans and Vietnam Veterans Receiving Cognitive Processing Therapy. Journal of Traumatic Stress, Vol 25, No. 1, p 25-32.
3. Ehlers,A., Clark, D.M., (2000). A cognitive model of posttraumatic stress disorder. Behavior Research and Therapy, Vol 38, p. 391-345. Education-transition (2017). Retrieved from website https://www.militarytimes.com Housing First, Inc. (2016). Retrieved from site https://hfal.org HUD exchange annual report of estimates on the homeless (2015). Retrieved from site https://www.hudexchange.info/resources/documents/2015-AHAR-Part-1.pdf
4. Monson, C. M., Schnurr, P. P., Resick, P. A., Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related a post-traumatic stress disorder. Journal of Consulting and Clinical Psychology, 74(5), 898-907. https://dx.doi.org.libproxy1.usc.edu/10.1037/0022-006X.74.5.898
5. Morland, L.A., Hynes, A.K., Mackintosh, M., Resick, P.A., Chard, K.M., (2011). Group Cognitive Processing Therapy Delivered to Veterans via Telehealth: A Pilot Cohort. Journal of Traumatic Stress, Vol 24, No 4, p. 465-469. Pewresearch.org. The changing face of American veteran populations (2017). Retrieved from https://pewresearch.org/fact-tank/2017/11/10/the-changing-face-of-americans-veteran-population
6. Resick, P. A., Wachen, J. S., Dondaville, K. A., Pruiksma, K. E., Yarvis, J. S., Peterson, A. L., Young-McCaughan, S. (2017). Effect of group vs. individual cognitive processing therapy in active-duty military seeking treatment for a post-traumatic stress disorder. JAMA Psychiatry, 74(1), 28. Doi: 10.1001/jamapsychiatry.2016.2729 Veterans populations statistics. (2017). Retrieved from website https://www.va.gov/vetdata/veteran_population.asp
7. Curley, A.L. & Vitale, P.A. (2016). Population-Based Nursing: Concepts and Competencies for Advanced Practice (2nd ed.). New York, NY.: Springer Publishing.
8. Stoto, M. A. (2014). Population Health Measurement: applying performance measurement concepts in population health settings. EGEMs, 2(4).
9. Gotter. A. (2016). Behavioral Therapy. Healthline. Retrieved March 12, 2017, from https://www.healthline.com/health/behavioral-therapy#Whobenefits2
10. Martin, B. (2016). In-Depth: Cognitive Behavioral Therapy. Psych Central. Retrieved on April 2, 2017, from https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/ USDVA. (2015). Treatment of PTSD. Retrieved April 03, 2017, from https://www.ptsd.va.gov/public/PTSD-overview/basics/symptoms_of_ptsd.asp
11. Myers, D. (2016). Psychology. Asheville, NC: Soomo Learning. Available from hLp:// www.webtexts.com

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