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The Impact of Outpatient Programs on Veteran PTSD Treatment

The aftermath of conflict often leaves deep psychological scars on those who serve and observe its brutality. In Canada, research indicates that around 10% of veterans who have engaged in combat zones may develop post-traumatic stress disorder (PTSD), while many others may experience varying symptoms of this condition.

Treating PTSD presents unique challenges, primarily because its manifestations differ from one individual to another. Some people find that residing in an intensive rehabilitation facility aids their recovery, while others may flourish in outpatient settings. Additionally, certain individuals might benefit the most from a combination of both approaches.

This subject forms the basis of a recent study published in the Journal of Aggression, Maltreatment & Trauma, spearheaded by Walter Marcantoni of Concordia University. The research highlights the efficacy of intensive outpatient programs (IOPs), where participants engage with mental health professionals daily while residing in their local communities. The findings suggest that IOPs are equally effective as inpatient treatments, which typically involve a recovery period of six to twelve weeks in a controlled environment designed for healing. Notably, both IOPs and inpatient programs display higher completion rates compared to standard outpatient treatments, which often suffer from drop-out rates nearing 50%.

“For patients, this means that there are options when it comes to receiving care,” explains Marcantoni, who serves as an assistant professor in the Psychology Department and is the lead author of the study.

Examining the Distinctions between Veterans and Active Duty Service Members

Marcantoni and his research team at CIUSSS du l’Ouest-de-l’Île-de-Montréal conducted a comprehensive analysis of 32 studies that focused on PTSD treatment for both active military personnel and veterans within residential and IOP settings. Most of the studies were conducted in the United States, while others originated in the United Kingdom, Australia, and Israel.

Participants across these studies met established PTSD diagnostic criteria and frequently faced additional challenges, including conditions such as depression, anxiety, and substance abuse disorders.

Both inpatient and IOP formats provided various forms of therapy, notably cognitive processing therapy and cognitive behavioral therapy, often delivered in group environments. Complementary therapies were also prevalent, encompassing psychoeducation, anger management, medication management, and art therapy among other options.

“We found that the average improvements in scores from intake to discharge were quite comparable between residential clinics and IOPs. There was essentially no difference,” Marcantoni notes, emphasizing his role as the head of the Health Technology Assessment Unit at CIUSSS.

The researchers identified a significant disparity in outcomes based on the setting of the IOPs; private clinics tended to yield better results than those operated by the U.S. Department of Defense. They pointed out that privately run facilities primarily serve veterans, whereas government facilities predominantly cater to active duty personnel.

“Currently, we can only hypothesize, but it appears that IOPs are more beneficial for veterans compared to those in active service,” Marcantoni states. He elaborates that this could be due to lingering stigma around treatment and the nature of how treatment is accessed—active service members often receive mandatory treatment directives, while veterans have the autonomy to choose to enroll voluntarily.

This research marks a pioneering effort to compare the effectiveness of residential clinics versus IOPs for treating PTSD. Marcantoni expresses hope that subsequent studies will delve deeper into the reasons behind the discrepancies in results from private versus government-operated clinics, potentially guiding adjustments to treatment approaches tailored to the specific needs of different populations.

Source
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