Treating PTSD in Military Personnel

A Clinical Handbook

Edited by Bret A. Moore and Walter E. Penk
Foreword by Matthew J. Friedman

Hardcovere-bookprint + e-book
Hardcover
October 7, 2011
ISBN 9781609186357
Price: $50.00 $42.50
382 Pages
Size: 6" x 9"
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e-book
December 20, 2011
ePub and PDF ?
Price: $50.00 $42.50
382 Pages
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print + e-book
Hardcover + e-Book (ePub and PDF) ?
Price: $100.00 $55.00
382 Pages
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This practical volume covers the full range of effective treatments for PTSD and discusses their implementation with service members and veterans. The focus is on how to meet this population's unique needs. From conducting a thorough assessment to choosing an appropriate psychosocial or pharmacological treatment, the expert editors and contributors provide guidance based on years of experience in military contexts. The norms and values of military culture are discussed. Chapters thoroughly describe available therapies, review their strengths and limitations, and use illustrative case examples to demonstrate the treatments in action. Also addressed are clinical issues and co-occurring problems that can arise in this population, such as traumatic brain injury and substance abuse, and strategies for dealing with them.

“A comprehensive, practical resource for clinicians and others who treat military personnel....I highly recommend this book to mental health professionals, chaplains, and health care providers who may work with the military. It may also be of interest to military members and their families, and treatment providers who are new to the VA system.”

International Journal of Emergency Mental Health


“From leaders in the field, this is one of the most comprehensive books available on PTSD. It covers all the major treatment approaches, as well as associated clinical issues, and is the first volume to apply this amazingly useful knowledge to the specific needs of Service Members and Veterans. Case vignettes bring each treatment approach to life. This is a 'must read' for anyone working with the military or with PTSD patients more broadly, and will give students preparing to intern in a VA hospital the cultural competence needed to work within the military culture. I am grateful for the publication of this gem of a book.”

—Barbara Olasov Rothbaum, PhD, ABPP, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine


“While the treatment of PTSD in combat veterans is still evolving, this book provides an impressive review of the most thoroughly studied psychological treatments. Synthesizing two decades' worth of research, the volume offers clinicians valuable information. Of equal importance, it offers hope that even more progress will be made in addressing this often chronic condition.”

—Bessel A.van der Kolk, MD, Medical Director, The Trauma Center at Justice Resource Institute; Professor of Psychiatry, Boston University School of Medicine


“The book is very clearly written and offers straightforward explanations of important scientific concepts. It features vital information to guide evaluation, diagnostic assessment, and decision making about clinical care for service members and veterans with PTSD. The book comes at a very appropriate time. I believe it will quickly become an essential item in the clinical arsenal of mental health professionals who interact with service members and veterans.”

—Alexander Neumeister, MD, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY


“The mental health community can help pay the debt of gratitude owed to service members and veterans by providing consensus best practices in an ecologically valid and culturally aware manner. This requires both a rigorous application of evidence-based assessment and treatment approaches and a steadfast appreciation of the military ethos and the unique biological, behavioral, cognitive, and spiritual impact of combat and operational stress and trauma. In this excellent and timely book, Moore and Penk have assembled experts who provide state-of-the-art strategies for helping service members and veterans recover from the psychic wounds of war.”

—Brett T. Litz, PhD, Departments of Psychiatry and Psychology, Boston University; Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System

Table of Contents

Introduction: PTSD in the Military, Bret A. Moore and Walter E. Penk

I. Treatment Approaches for PTSD in Military Personnel

1. Understanding and Working within the Military Culture, Bret A. Moore

2. Issues in Assessment of PTSD in Military Personnel, Frank Castro, Jasmeet P. Hayes, and Terence M. Keane

3. Prolonged Exposure Therapy, Alan L. Peterson, Edna B. Foa, and David S. Riggs

4. Cognitive Processing Therapy, Amy M. Williams, Tara E. Galovski, Karen A. Kattar, and Patricia A. Resick

5. Eye Movement Desensitization and Reprocessing, Mark C. Russell, Howard Lipke, and Charles Figley

6. Virtual Reality Exposure Therapy, Greg M. Reger and Kevin M. Holloway

7. Psychodynamic Psychotherapy, Harold Kudler

8. Group Therapy, David W. Foy, Kent D. Drescher, Patricia J. Watson, and Iya Ritchie

9. Couple and Family Therapy, Danielle J. Maack, Judith A. Lyons, Kevin M. Connolly, and Michael Ritter

10. Psychopharmacological Treatment, William M. Sauvé and Stephen M. Stahl

11. Psychosocial Rehabilitation, Walter E. Penk, Dolores Little, and Nathan Ainspan

II. Specific Clinical Issues Associated with PTSD

12. Co-Occurring Affective and Anxiety Disorders, Eric C. Meyer, Nathan A. Kimbrel, Matthew T. Tull, and Sandra B. Morissette

13. Co-Occurring Substance Use Disorders, Marc I. Kruse, Laurie E. Steffen, Nathan A. Kimbrel, and Suzy Bird Gulliver

14. Traumatic Brain Injury, Jennifer J. Vasterling, Mieke Verfaellie, and Susan M. McGlynn

15. Sexual Assault in the Military, Alina M. Surís and Julia C. Smith

16. Sleep Disorders, William L. Brim and David S. Riggs

17. Managing the Service Member with Suicidal Ideation, Nancy A. Skopp, David D. Luxton, Nigel Bush, and M. David Rudd

18. Anger, Aggression, and Violence, Eric B. Elbogen, Sally C. Johnson, and Jean C. Beckham

19. Resiliency Building as a Means to Prevent PTSD and Related Adjustment Problems in Military Personnel, Donald Meichenbaum

Appendices. Resources

Appendix A. Recommendations for Gaining Military Cultural and Clinical Competence

Appendix B. Military Organizations and Programs

Appendix C. Select Common Military Abbreviations


About the Editors

Bret A. Moore, PsyD, ABPP, is founder of Military Psychology Consulting and a board-certified clinical psychologist in San Antonio, Texas. He is a former active-duty Army psychologist and two-tour veteran of Iraq. Dr. Moore is coauthor or coeditor of a number of books on military psychotherapy and counseling and on pharmacotherapy for psychologists. He is a recipient of the Arthur W. Melton Award for Early Career Achievement in Military Psychology from Division 19 of the American Psychological Association and the Early Career Achievement Award from Division 18, and is a Fellow of the American Psychological Association.

Walter E. Penk, PhD, ABPP, is Professor of Psychiatry and Behavioral Sciences at Texas A&M College of Medicine and consultant to the Veterans Health Administration’s VISN 17 VA Center of Excellence in Stress Disorders Research and VA Rehabilitation Research and Development in Washington, DC. Dr. Penk's research and more than 135 publications focus on validating treatments for co-occurring PTSD, addictions, and other mental disorders. He is a recipient of a Presidential Citation, the Division 18 Harold Hildreth Award from the American Psychological Association, a VA Distinguished Career Award, and recognition from the American Rehabilitation Counseling Association, and is a Fellow of the American Psychological Association.

Contributors

Nathan Ainspan, PhD, Civilian Personnel Evaluation Agency, United States Army, Alexandria, Virginia

Jean C. Beckham, PhD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, and VA Mid-Atlantic Health Care Network (VISN 6) Mental Illness Research, Education, and Clinical Center–Durham VA Medical Center, Durham, North Carolina

William L. Brim, PhD, Center for Deployment Psychology, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland

Nigel Bush, PhD, National Center for Telehealth and Technology, Tacoma, Washington

Frank Castro, PhD, National Center for PTSD, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, MA

Kevin M. Connolly, PhD, G.V. (Sonny) Montgomery VA Medical Center, VA South Central (VISN 16) Mental Illness Research, Education and Clinical Center, and Division of Psychology, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi

Kent D. Drescher, PhD, National Center for PTSD, Menlo Park, California

Eric B. Elbogen, PhD, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, and VA Mid-Atlantic Health Care Network (VISN 6) Mental Illness Research, Education, and Clinical Center–Durham VA Medical Center, Durham, North Carolina

Charles Figley, PhD, Traumatology Institute, Tulane University, New Orleans, Louisiana

Edna B. Foa, PhD, Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

David W. Foy, PhD, Graduate School of Education and Psychology, Pepperdine University, Malibu, California

Tara E. Galovski, PhD, Center for Trauma Recovery, University of Missouri–St. Louis, St. Louis, Missouri

Suzy Bird Gulliver, PhD, VA Heart of Texas Health Care Network (VISN 17) Center of Excellence for Research on Returning War Veterans, Department of Psychiatry and Behavioral Sciences, Texas A&M Health Science Center, Waco, Texas

Jasmeet P. Hayes, PhD, National Center for PTSD, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts

Kevin M. Holloway, PhD, National Center for Telehealth and Technology, Tacoma, Washington

Sally C. Johnson, MD, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Durham, North Carolina

Karen A. Kattar, PhD, Phoenix VA Health Care System, Phoenix, Arizona

Terence M. Keane, PhD, National Center for PTSD, VA Boston Healthcare System, Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts

Nathan A. Kimbrel, PhD, VA Heart of Texas Health Care Network (VISN 17) Center of Excellence for Research on Returning War Veterans, Department of Psychiatry and Behavioral Sciences, Texas A&M Health Science Center, Waco, Texas

Marc I. Kruse, PhD, VA Heart of Texas Health Care Network (VISN 17) Center of Excellence for Research on Returning War Veterans, Department of Psychiatry and Behavioral Sciences, Texas A&M Health Science Center, Waco, Texas

Harold Kudler, MD, VA Mid-Atlantic Health Care Network (VISN 6) Mental Illness, Research and Education Center–Durham VA Medical Center, and Department of Psychiatry, Duke University Medical Center, Durham, North Carolina

Howard Lipke, PhD, Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, Illinois

Dolores Little, PhD, U.S. Department of Veterans Affairs, Washington, D.C (retired)

David D. Luxton, PhD, National Center for Telehealth and Technology, Tacoma, Washington

Judith A. Lyons, PhD, G. V. (Sonny) Montgomery VA Medical Center, VA South Central Health Care Network (VISN 16) Mental Illness Research, Education and Clinical Center, and Division of Psychology, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi

Danielle J. Maack, PhD, G. V. (Sonny) Montgomery VA Medical Center and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi

Susan M. McGlynn, PhD, Psychology Service, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts

Donald Meichenbaum, PhD, Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada, and the Melissa Institute for Violence Prevention and Treatment, Miami, Florida

Eric C. Meyer, PhD, VA Heart of Texas Health Care Network (VISN 17) Center of Excellence for Research on Returning War Veterans, and Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, Waco, Texas

Bret A. Moore, PsyD, ABPP, Military Psychology Consulting, San Antonio, Texas

Sandra B. Morissette, PhD, VA Heart of Texas Health Care Network (VISN 17) Center of Excellence for Research on Returning War Veterans, and Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, Waco, Texas

Walter E. Penk, PhD, ABPP, Department of Psychiatry and Behavioral Sciences, Texas A&M College of Medicine, New Braunfels, Texas

Alan L. Peterson, PhD, Department of Psychiatry, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas

Greg M. Reger, PhD, National Center for Telehealth and Technology, Tacoma, Washington

Patricia A. Resick, PhD, National Center for PTSD, VA Boston Healthcare System, and College of Arts and Sciences, Boston University, Boston, Massachusetts

David S. Riggs, PhD, Center for Deployment Psychology, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland

Iya Ritchie, MA, Graduate School of Education and Psychology, Pepperdine University, Malibu, California

Michael Ritter, PhD, G.V. (Sonny) Montgomery VA Medical Center, and Division of Psychology, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi

M. David Rudd, PhD, College of Social and Behavioral Science, University of Utah, Salt Lake City, Utah

Mark C. Russell, PhD, School of Applied Psychology, Counseling, and Family Therapy, Antioch University, Seattle, Washington

William M. Sauvé, MD, Department of Mental Health, Naval Medical Center San Diego, San Diego, California

Nancy A. Skopp, PhD, National Center for Telehealth and Technology, Tacoma, Washington

Julia C. Smith, PsyD, VA North Texas Health Care System, and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas

Stephen M. Stahl MD, PhD, Department of Psychiatry, University of California, San Diego, San Diego, California, and Department of Psychiatry, University of Cambridge, United Kingdom

Laurie E. Steffen, BA, VA Heart of Texas Health Care Network (VISN 17) Center of Excellence for Research on Returning War Veterans, and Department of Psychiatry and Behavioral Sciences, Texas A&M Health Science Center, Waco, Texas

Alina M. Surís, PhD, VA North Texas Health Care System, and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas

Matthew T. Tull, PhD, Department of Psychiatry and Human Behavior, Division of Psychology, University of Mississippi Medical Center, Jackson, Mississippi

Jennifer J. Vasterling, PhD, Psychology Service and VA National Center for PTSD, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts

Mieke Verfaellie, PhD, Memory Disorders Research Center, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts

Patricia J. Watson, PhD, National Center for PTSD, White River Junction, Vermont

Amy M. Williams, PhD, private practice, Flower Mound, Texas

Audience

Mental health practitioners who work with current or former service members and their families, including clinical psychologists, psychiatrists, social workers, nurses, and counselors.

Course Use

May serve as a supplemental text in graduate-level courses.