Moving Forward with Web-Based PTSD Therapy
Life is stressful, but war takes that stress to an altogether different level. Psychology professor Steve Maisto of the College of Arts and Sciences wants to help combat veterans with post-traumatic stress disorder (PTSD) and substance misuse issues. Maisto and colleagues Andrew Rosenblum, Lisa Marsch and Kyle Possemato, along with a team that includes four SU graduate students, have developed and are testing a web-based, patient self-management program—Coming Home and Moving Forward—that teaches cognitive-behavioral therapy skills to vets to help them manage PTSD symptoms and alcohol and drug abuse.
Maisto, whose research focuses on alcohol and drug assessment and treatment methods, says the online format suits the more than 1.6 million veterans who served in the Iraq and Afghanistan campaigns. “The stigma of mental health problems remains a major barrier to getting help; not having to go to specialty care for a substance abuse or PTSD program is a big plus with them,” he says. “The vets also liked the computer-delivered, self-paced format. These veterans are younger than the average VA patient and comfortable using computer technology.”
The program content was derived from successful cognitive-behavioral therapy treatments for substance use disorders, and utilizes an interactive delivery system that has been proven effective in promoting knowledge and skills. Vets move through exercises designed to help them develop and strengthen their ability to self-regulate, and cope with anxious, trauma-related thoughts that contribute to maladaptive behaviors. The self-management strategies encourage and reinforce them to actively learn and apply the new skills to manage their problems.
For example, one of the 24 modules, "Identifying Automatic Thoughts," introduces the concept of traumatic thoughts, and how certain emotions and environmental events can elicit thoughts that can have a damaging influence on emotions and behavior. Another, "Challenging Automatic Thoughts," is a series of exercises that asks veterans to tackle distorted thinking by developing facts that dispute the troubled thought and constructing alternative responses.
The veterans like the program. “One vet commented that he loved the program and finds it very helpful, and that others have noticed a change in him,” says Maisto, who’s glad he can help. “My work with them has exposed me to the very substantial, in some cases unimaginable, ordeals and trauma they have endured for the sake of our national interests. I feel indebted to them, as should all U.S. citizens.”
With funding from the U.S. Department of Veterans Affairs and the National Institute on Alcohol Abuse and Alcoholism, Maisto helped develop the web intervention at the VA Center of Integrated Healthcare in Syracuse, where he has served as executive director since 2007. The clinical trial is in its fifth and final year; outcomes and followup will dictate what comes next. “I’ve been involved with the VA in various ways—clinician, researcher, administrator—for over 30 years, including pro bono clinical work at the Syracuse VA,” Maisto says. “I get a lot of gratification, both personal and professional, in doing this work.”
This story was written by John Martin and originally appeared in Syracuse University Magazine.