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J Altern Complement Med. 2019 Mar;25(S1):S147-S152. doi: 10.1089/acm.2018.0424.

Evaluation of an Integrative Post-Traumatic Stress Disorder Treatment Program.

Author information

1
1 Goverment and Public Services, Deloitte Consulting LLP, Los Angeles, CA.
2
2 Military Health Research, Henry M. Jackson Foundation for Advancement of Military Medicine, Bethesda, MD.
3
3 RAND Health, RAND Corporation, Santa Monica, CA.
4
4 Private Practice, Beverly Hills, CA.
5
5 Biostatistics, Becton Dickinson, Mclean, VA.
6
6 United States Navy, 8th Marine Regiment, 2d Marine Division; Marine Corps Base Camp Lejeune, NC.

Abstract

OBJECTIVES:

Post-traumatic stress disorder (PTSD) and combat-related stress can be refractory, pervasive, and have a devastating impact on those affected, their families, and society at large. Challenges dealing with symptoms may in turn make a servicemember more susceptible to problems, including alcohol abuse, interpersonal conflict, and occupational problems. An effective treatment strategy will address multifactorial issues by using a holistic multimodal approach. Back on Track is an intensive outpatient program utilizing a holistic philosophy and multimodal treatments to provide a whole systems approach for the treatment of combat-related stress reactions and PTSD in active duty servicemembers.

DESIGN/SETTING/SUBJECTS:

An explanatory, sequential, mixed-methods program evaluation was conducted to assess the effectiveness of a PTSD and combat stress treatment program. Quantitative outcomes were collected and analyzed on 595 participants at pre- and postinterventions and 6-week follow-up and qualitative data were gathered through participant interviews.

INTERVENTION:

The manualized program uses a multimodal, psychoeducational group therapy format with a holistic approach for treating combat stress, increasing resiliency, and assisting with reintegration. Rotating providers visit from other programs and services to deliver content in bio-psycho-social-spiritual domains, including didactic lectures on mindfulness and the relaxation response and daily sessions of yoga nidra and meditation.

OUTCOME MEASURES:

The primary outcome measure was PTSD symptom severity assessed with the PTSD Checklist-Military Version (PCL-M). Secondary outcomes included self-efficacy, knowledge, use, and satisfaction. Quantitative data were contextualized with interview data.

RESULTS:

Results demonstrated a highly statistically significant effect of the program when comparing within-subject PCL-M scores before and after program participation, signed rank S (N = 595) = -47,367, p < 0.001. This translates to a moderate effect size, Cohen's d (N = 595) = -0.55, 95% confidence interval = -0.62 to -0.47, and a mean decrease of 7 points on the PCL-M at postintervention, demonstrating response to treatment. There were significant increases in knowledge and self-efficacy and high levels of satisfaction with the program overall, content, materials, and delivery.

CONCLUSIONS:

The treatment program has served ∼800 servicemembers since inception and has since expanded to five installations. The provision of whole systems care where the approach is holistic, multimodal, and multidisciplinary may be a way forward for the successful treatment of PTSD and other debilitating behavioral health conditions in military contexts and beyond.

KEYWORDS:

PTSD; integrative medicine; military health; program evaluation

PMID:
30870017
DOI:
10.1089/acm.2018.0424
[Indexed for MEDLINE]

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