T ha nk yo u fo r jo ining us T ha nk yo u to o ur spo nso rs, - PowerPoint PPT Presentation

T ha nk yo u fo r jo ining us  T ha nk yo u to o ur spo nso rs, APA Divisio n 19 (Milita ry Psyc ho lo g y) a nd Divisio n 18 (Psyc ho lo g ists in Pub lic He a lth, VA Se c tio n)  T he re will b e a Q&A a t the e nd o f the we b ina r  Ple a se write q ue stio ns in the c ha t b o x  We will try to mo nito r a s b e st we c a n Rya n.He ss@ VA.g o v

Opinio ns E xpre sse d in the We b ina r  T he o pinio ns e xpre sse d in the we b ina r a re so le ly tho se o f the pre se nte rs a nd do no t ne c e ssa rily re pre se nt tho se o f the VA, Do D, o r a ny o the r a g e nc y o r pro fe ssio na l a sso c ia tio n.

We b ina r Co mpo ne nts  RE VI E W o f the pro b le m  RE SUL T S o f o ur study  RE COMME NDAT I ONS fo r T x  RE SOURCE S fo r pro vide rs

Re vie w o f the Pro b le m  23% o f I ra q a nd Afg ha nista n ve te ra ns e xpe rie nc e PT SD sympto ms (F ulto n e t a l., 2015)  De pre ssio n is the se c o nd mo st c o mmo n me nta l he a lth c o nditio n a mo ng OE F / OI F / OND ve te ra ns (E sio b u, 2015)  22% to 40% o f OE F / OI F / OND ve te ra ns sc re e n po sitive fo r a lc o ho l misuse (Ca lho un, E lte r, Jo ne s, K udle r, & Stra its-T ro ste r, 2008; Ha wkins, L a pha m, K ivla ha n, & Bra dle y, 2010)

Pre se nt Study De sc riptio n o f va ria b le s:  PT SD se ve rity (I V)  De pre ssio n se ve rity (I V)  Alc o ho l Use se ve rity (DV)  Re la tio nship Sa tisfa c tio n (Mo de ra to r)  Ag e , le ng th o f re la tio nship, disc ha rg e sta tus, se rvic e in the Army (Co va ria te s)  Pa rtic ipa nts: 594 wo me n, 303 me n

Pre se nt Study Purpo se o f the Pre se nt Study:  F ills a g a p in the e xta nt lite ra ture  Be tte r unde rsta nd the de le te rio us e ffe c ts o f PT SD a nd its re la tio nship to a lc o ho l use  E luc ida te the po te ntia lly re sto ra tive sig nific a nc e o f a sa tisfying re la tio nship

Pre se nt Study Hypo the se s:  1. F o r tho se individua ls e xpe rie nc ing PT SD sympto ms a nd De pre ssive sympto ms, tho se individua ls with hig he r le ve ls o f re la tio nship sa tisfa c tio n will e xpe rie nc e lo we r le ve ls o f a lc o ho l use .  2. F o r tho se individua ls e xpe rie nc ing PT SD sympto ms a nd De pre ssive sympto ms, tho se individua ls with lo we r le ve ls o f re la tio nship sa tisfa c tio n will e xpe rie nc e hig he r le ve ls o f a lc o ho l use .  3. F o r b o th me n a nd wo me n who e xpe rie nc e PT SD a nd De pre ssio n, re la tio nship sa tisfa c tio n will mo de ra te a lc o ho l use .

K e y T a ke a wa y  T he re ma y b e c o nside ra b le b e ne fit to inc luding the ro ma ntic pa rtne r in psyc ho the ra py  PT SD, SUD, a nd de pre ssio n a ll impa c t the ro ma ntic re la tio nship  Ye t c o uple s the ra py is a n unde r-utilize d mo da lity

Atte ntio n to Cultura l I ssue s  I nc luding the ro ma ntic pa rtne r ma y b e a wa y o f inc re a sing c ultura l se nsitivity  Ano the r pe rspe c tive is he a rd/ c o nside re d  Ma ny c ulture s a re c o lle c tivistic  F o r tho se individua ls fro m c o lle c tivistic c ulture s, individua l the ra py c a n fe e l unc o mfo rta b le  Milita ry c ulture is c e rta inly c o lle c tivistic  F o c us is o n the missio n, te a mwo rk is e mpha size d, c a ring fo r yo ur unit/squad/platoon is prioritized (“service before self” and “selfless service”)  Co uple s the ra py ma y b e a wa y to ta p into tha t c o o pe ra tive / c o lla b o ra tive me nta lity o f the milita ry

Po te ntia l Be ne fits to Co uple s T x  Including a romantic partner may decrease the service member/veteran’s anxiety  Ca n fo c us o n no n-thre a te ning issue s first  He lp-se e king  Se tting a ppro pria te b o unda rie s  Se lf-c a re  Asse rtive c o mmunic a tio n  Ho w to use time o uts  Ac tive liste ning  Stre ng ths-b a se d a ppro a c h (wha t is wo rking we ll in the re la tio nship)

Po te ntia l Be ne fits to Co uple s T x  I nc luding a ro ma ntic pa rtne r o ffe rs the c linic ia n the ability to view the patient’s interpersonal style in real time  I nc luding a ro ma ntic pa rtne r o ffe rs the o ppo rtunity to pro vide psyc ho e duc a tio n  Ofte n, pa rtne rs kno w ve ry little a b o ut PT SD, SUD, o r de pre ssio n

We a ving Co uple s T he ra py into T x  Ca n b e do ne b e fo re a tra uma -info rme d a ppro a c h  Ma y se rve to e nha nc e mo tiva tio n/ re a dine ss  Ca n b e utilize d to a ddre ss CC  CBT -SUD, E F T , Be ha vio ra l Co uple s T he ra py fo r AUD, Co g nitive Be ha vio ra l Co njo int T he ra py fo r PT SD  Ca n b e use d a s a n a djunc t/ supple me nt to individua l T x  Ca n b e pa rt o f a fte r-c a re  Afte r sta b iliza tio n/ sympto m de c re a se

As se e n thro ug h the le ns o f c o uple s T x De pre ssion PT SD SUD Whe n o ne me mb e r o f a ro ma ntic A ha llma rk fe a ture o f PT SD is a vo ida nc e . SUD c a n b e a n a tte mpt to re la tio nship is de pre sse d, the re c a n b e T his a vo ida nc e c a n c e rta inly ma nife st in iso la te / numb / fo rg e t. Ofte n the te nde nc y fo r the o the r pa rtne r to a nd c a use da ma g e to the ro ma ntic c o nc e ptua lize d a s a fo rm o f a vo ida nc e b e c o me de pre sse d (ne g a tive re la tio nship. fe e db a c k lo o p) I t ha s b e e n sug g e ste d tha t de pre ssio n is So me the o re tic a l o rie nta tio ns (e .g ., E F T ) Almo st a ll tre a tme nts fo r SUD e mpha size a fo rm o f e xc e ssive se lf-fo c us (Rumina te e nc o ura g e a ppro a c h b e ha vio rs the impo rta nc e o f so c ia l suppo rt (e .g ., o n pe rso na l g uilt, sha me , dislike , AA/ NA, CBT -SUD, MI , Ce le b ra te pe rc e ive d fa ilure s, e tc .) Re c o ve ry, e tc .) Se e king this so c ia l suppo rt c a n b e g in with c o ming to the ro ma ntic pa rtne r ho ne stly a nd in a sta te o f vulne ra bility I t ha s b e e n re c o mme nde d tha t o ne L e a rning to a ppro a c h the ro ma ntic CBT -SUD e nc o ura g e s the utiliza tio n o f a “Supportive Significant Other” which re me dy fo r the e xc e ssive se lf-fo c us tha t pa rtne r c a n b e use d a s sc a ffo lding to c an be a ro ma ntic pa rtne r a nd c a n b e c a n pe rpe tua te de pre ssio n is to ha ve e nc o ura g e the se rvic e the individual fo c us o n so me o ne e lse me mb e r/ ve te ra n to a ppro a c h o the r a nyo ne tha t c a re s fo r the ve te ra n a nd (e .g ., ro ma ntic pa rtne r) a nd le a rn to a vo ide d issue s. T his ma y se rve to stre ng the ns the ir re c o ve ry c ultiva te sympa thy/ e mpa thy a me lio ra te the PT SD.

Additio na l Be ne fits  With the re c e nt inc re a se d utiliza tio n o f te le he a lth, it ma y be easier to access the service member/veteran’s ro ma ntic pa rtne r (le ss wo rk fo r the m to c o me in fo r the the ra py se ssio n)  T his ma y b e a wa y fo r us to e xpa nd o ur c a re fo r o ur pa tie nts. I n c e rta in VA se tting s, ve te ra ns ha ve b e e n re fe rre d fo r c o uple s the ra py in the c o mmunity b e c a use the ir VA did no t o ffe r c o uple s the ra py o r the wa it fo r c a re wa s to o g re a t

Po te ntia l Ba rrie rs to Co uple s T x  Ce rta inly the re a re c o ntra indic a tio ns (e .g ., do me stic vio le nc e )  T he re ma y b e time s whe n it is c linic a lly indic a te d to fo c us o n PT SD/ SUD/ de pre ssio n in a n individua l fo rma t  Ma ny pro vide rs a re wa ry o f do ing dya dic the ra py  May fear becoming “the couples therapist”  Ma y fe e l unq ua lifie d  I nde e d, VA o ffe rs c o mpa ra tive ly fe w tra ining s fo r c o uple s the ra py

Re so urc e s  Co uple s Co a c h a pp (a va ila b le fo r Ma c a nd Andro id de vic e s)  Co uple s Co a c h wa s ma de b y the mo b ile me nta l he a lth te a m o f the Na tio na l Ce nte r fo r PT SD, Disse mina tio n & T ra ining Divisio n  E F T we b ina r a va ila b le a t http:/ / va -e e rc -e e s.a do b e c o nne c t.c o m/ pd6wq s72p0p2/  VA E F T listse rv  E ma il Je rika .No ro na @ va .g o v  Ca re g ive r Suppo rt Pro g ra m (a va ila b le a t ma ny VA ho spita ls)  Wa rrio r to So ul Ma te (W2SM) re tre a t  VA-spo nso re d tra ining s fo r I nte g ra tive Be ha vio ra l Co uple s T he ra py, CBT -SUD, Co g nitive Be ha vio ra l Co uple s T he ra py fo r PT SD  F a mily Se rvic e s Sha re Po int Site fo r VA c linic ia ns  https:/ / va ww.po rta l.va .g o v/ site s/ OMHS/ fa milyse rvic e s/ de fa ult.a spx

Sa mple a nd Me tho d  Study de sig ne d to a sse ss re la tio nship sa tisfa c tio n a nd func tio n  Pa rtne re d me n a nd wo me n re c ruite d thro ug h so c ia l me dia  Surve ys we re simila r b ut no t ide ntic a l a nd c o lle c te d a b o ut 18 mo nths a pa rt.  Me a sure s we re c o mple te d o nline , a no nymo usly  Study funde d b y Divisio n 19 – So c ie ty fo r Milita ry Psyc ho lo g y