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Training Needs for the Treatment of Combat-Related Posttraumatic Stress Disorder: A Survey of Department of Defense Clinicians

United States Naval Hospital, Bremerton, Washington

Steven M. Silver

Department of Veterans Affairs, VA Medical Center, Coatesville, Pennsylvania, Steven.Silver2{at}va.gov

In 2004, the United States Departments of Veterans Affairs (VA) and Defense jointly published clinical-practice guidelines for posttraumatic stress disorder (CPG-PTSD). These identified 4 psychotherapies for PTSD: cognitive therapy, eye-movement desensitization and reprocessing, exposure therapy, and stress inoculation therapy. One hundred thirty-seven mental-health professionals employed by the military or the VA were surveyed as to whether they used any of these psychotherapies and the extent of their training in them. Ninety percent of respondents reported not using any of the 4 psychotherapies. Of those who did, most had received their training before their affiliation with the military, and only a handful had training in the specific use of psychotherapy with PTSD. The lack of available, CPG-identified, effective psychotherapies is discussed as a barrier to treatment, as are possible reasons the psychotherapies are not used. A brief description of a training program is provided along with suggestions for the future.

Key Words: military • EMDR • trauma training

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