PTSD therapy reaches soldiers in the field

Just days after a suicide attack in Afghanistan like the one in April that killed three Ohio Guardsmen and wounded five others, another fight begins — for a soldier’s mental health.

In battlefield interviews from Afghanistan with the dayton Daily News, two military mental health providers revealed how they’re trying to get the jump on post-traumatic stress before a veteran comes home.

“There’s now a much bigger emphasis on prevention and early intervention,” said Army Capt. Donell Barnett, a clinical psychologist whose combat stress-control unit operates the Warfighter Restoration Center at Bagram Airfield near Kabul.

Still, prospects for completely warding off PTSD — an illness that may take months or even years to develop — aren’t good.

“We thought we could prevent the whole of PTSD,” Barnett said. “The consensus now is that you can’t prevent neurobiological responses, but you can prevent it from being worse than it would be otherwise.”

In other words, there’s no cure for nightmares and flashbacks — only a way to manage them.

“We do lessen the severity of the situation,” Barnett said.

The lessening of anxiety begins 24 to 72 hours after a critical event — that lethal suicide attack in April, for example — when a behavioral health officer like Maj. Maria Kimble, of the Ohio Army National Guard, makes contact with the affected unit.

Kimble, of Massillon, is the only mental health provider for the roughly 1,500 deployed guardsmen of the 37th Infantry Brigade Combat Team, which lost those three soldiers, all from the Columbus area, in April.

The brigade contains numerous soldiers from the Miami Valley.

As part of “traumatic event management,” Kimble first gathers everyone involved for a confidential debriefing, in part to alleviate guilt.

“They seem to be very useful in getting some closure,” said Kimble, herself a recipient of a Bronze Star. “Soldiers have always been very open with me. They always get very emotional.”

Because everybody responds to trauma differently, Kimble is a proponent of providing soldiers with self-care.

She gives soldiers journals, encourages art therapy and massage therapy, if possible, and offers a yoga workshop five days a week.

“Anything I can think of,” she said.

She also passes out stress balls.

“Lots of stress balls,” she said.

The approach to dealing with combat stress in the post-Sept. 11 era differs from the Vietnam War, Barnett said, when mental health providers would have been posted at a major hospital.

“Once a service member is separated from their unit,” he said, “it sets them up to start questioning themselves. They’re removed from that natural support group. By keeping them closer to the fight, you don’t make them outcasts.

“When it’s treated closer to the fight, we see much better improvement.”

The Warfighter Restoration Center works with referrals from every branch of service.

There, troops embark on a voluntary, three-day program covering such topics as anger management and sleep hygiene, along with more personalized care, Barnett said.

The stigma of mental illness is lessening, he said, out of sheer necessity. More service members are seeking help because they’re seeing the link between personal problems and multiple deployments.

“We’ve come to a place where it’s unavoidable,” he said. “We’ve been at war for so long.”

Key to treatment at the restoration center is a therapy dog — a yellow Lab named Major Timmy.

“Everybody loves to pet Major Timmy,” Barnett said, “and that sparks the conversation. That’s been hugely successful. I was skeptical of it at first until I got here. He is a rock star.”

Of the troops that complete the program — Barnett’s unit has treated more than 100 in the year they’ve operated the center — 97 percent return to duty, he said, with a 25 percent reduction in stress symptoms.

While antidepressants can be prescribed for service members while they are still in the field, he said, the preferred first step is having the service member go to a restoration center.

“The concept is to give them enough of a break so they can complete the deployment successfully,” he said.

His team also goes on “walkabouts” in the field, just talking to soldiers.

Kimble, of the Ohio Guard, said she unfortunately isn’t able to track what happens when a soldier returns home.

She can only pass out stress balls now and hope for the best.

“As a therapist, I feel helpless,” she said. “I’m helping them, sometimes only to send them back into the same environment where they might experience even bigger trauma.”

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(c)2012 the Dayton Daily News (Dayton, Ohio)

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Article source: http://www.apa.org/news/psycport/PsycPORTArticle.aspx?id=knightridder_2012_05_27__0000-2834-DY-PTSD-therapy-reaches-soldiers-in-the-field-0527-20120527.xml