Synthesis of the Research Studies

Studies have confirmed that a large number of veterans and active duty military officers have post-traumatic stress disorder (PTSD). This justifies the need to implement an effective PTSD treatment intervention to improve the lives of those affected. One of the proposed interventions for PTSD in veterans is exposure therapy. Studies addressing various aspects of exposure therapy have been conducted to determine the effectiveness of this approach. Wangelin and Tuerk (2014), for instance, conducted a study to determine whether PTSD in active combat soldiers should be treated or not. In this study, the researchers looked at the ethical issues associated with exposure therapy as a form of treatment for PTSD.

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The researchers pointed out that although exposure oriented interventions are among the most widely-researched interventions, numerous issues concerning these interventions are yet to be addressed. Very few studies have addressed the issue of administering exposure therapy in active duty context. Studies using various research groups, populations and contexts have, nonetheless, shown that exposure therapy can be applied in managing PTSD in veterans. In this study, the researcher reviewed the manualized exposure-oriented protocol for PTSD as well as the clinical procedures for prolonged exposure therapy. The researchers concluded that it is of paramount importance to provide combat veteran populations with effective, direct access to PTSD interventions. Wangelin and Tuerk (2014) noted that whereas there are no ethical issues with the application of exposure therapy in retired war veterans, some ethical issues arise when this intervention is applied in active combat zones. The researchers pointed out that since individual, social, family functioning and physical capabilities are greatly affected in individuals with PTSD, the use of exposure therapy would be a valuable clinical endeavor.

The article by Rutt, Oehlert, Krieshok, and Lichtenberg (2018) describes a study aimed at evaluating the Value of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs. The researchers noted that the veterans, who completed the exposure therapy intervention, experienced an approximately 20% reduction in PTSD symptoms.

It was also noted that veterans who failed to complete therapy experienced no change in PTSD symptoms. This led to the conclusion that the effectiveness of exposure therapy is largely dependent on completion of treatment. Rutt et al. (2018) also noted that the likelihood of experiencing a decrease in the severity of the symptoms was significantly higher among those who had severe PTSD during the start of the program. The researchers noted that exposure therapy could be applied for veterans with diverse racial and ethnic backgrounds. The study revealed that race and ethnicity did not influence the outcome of therapy.

Mott et al. (2014) describe a retrospective chart review aimed at determining the characteristics of the veterans who start and complete prolonged exposure therapy. The researchers pointed out that since PTSD is the most common mental health diagnoses among military veterans, there is a need to implement an effective intervention to improve management and prevent devastating consequences. The researchers found out that there was an increased likelihood of veterans seeking evidence-based psychotherapy (EBP) once a diagnosis of PTSD was made. The other finding of the study by Mott et al. (2014) was that the likelihood of clinicians beginning EBP was far much higher for veterans who presented with severe PTSD symptoms and functional impairment in comparison to those with less severe symptoms.

The article by Ghaffarzadegan, Ebrahimvandi, and Jalali (2016) describes a dynamic simulation model of PTSD for military personnel and veterans. The researchers wanted to answer crucial questions regarding PTSD in veterans. Some of these questions focus on the policies that can help mitigate PTSD and the trends of this disorder in the target population in the postwar era. The model postulated that over the next few years approximately 10% of the active duty military personnel would have PTSD. The researchers also postulated that resilience related policies have a higher potential to decrease the impact of PTSD than other policies.

Ghaffarzadegan et al. (2016) asserted that during postwar era screening and treatment have significant benefits in mitigating PTSD.

The study by Castillo, Lacefield, Baca, Blankenship, and Qualls (2014) also generated remarkable results in regards to the treatment of PTSD in military veterans. The researchers used women veterans as the main participants in the study. The study found out that group focused cognitive processing improves PTSD symptoms among women veterans. The study also found out that more treatment sessions do not always translate to improved outcomes for the patients.

Points of Inconsistencies and Contradictions

There were some inconsistencies noted in some of the articles reviewed. For instance, whereas Mott et al. (2014) and Rutt et al. (2018) pointed out that prolonged exposure therapy has the potential to reduce the severity of the PTSD symptoms among veterans Castillo et al. (2014) argued that numerous treatment sessions do not always yield the anticipated results. Castillo et al. (2014) pointed out there are numerous factors that contribute to better health outcome for PTSD veterans.

Support for Practice Change

The reviewed research articles have demonstrated their support of exposure therapy in the treatment of PTSD in military veterans. It has been revealed that exposure therapy provides military veterans with an opportunity to face their fear, anxiety, and uncertainties with courage.

Wangelin and Tuerk (2014) for instance noted that exposure therapy would be an invaluable clinical endeavor to resolve the devastating social, family functioning and physical impacts of PSD on individuals. Exposure therapy should be integrated into the treatment plan for military veterans presenting with PTSD symptoms.

Wangelin, B. C., & Tuerk, P. W. (2014). PTSD in active combat soldiers: to treat or not to treat.

Journal of Law and Medical Ethics, 42(2), 161-70. doi: 10.1111/jlme.121

32.

Type of Study: Quantitative Study Design Type: systematic review Framework/

Theory: Not indicated

Veteran clinical care setting

Concepts:

To determine the practicality of treating PTSD war veterans

Independent Variable: PTSD diagnosis

Dependent Variable: PTSD symptoms

Controlled Variable: None

The researchers found out that it is beneficial to treat veterans presenting with PTSD symptoms to improve their quality of life by helping them to deal with fear, anxiety and other PTSD symptoms. All barriers preventing veterans from accessing treatment post deployment should be addressed promptly

Level II

Rutt, B. T., Oehlert, M. E., Krieshok, T. S., & Lichtenberg, J. (2018). Effectiveness of Cognitive Processing Therapy and Prolonged

Type of Study: Quantitative study Design Type: Retrospective review

Communit y-Based Outpatient Clinics and VA Medical Centers in Arizona

Concepts: The study was aimed at evaluating the effectiveness of cognitive processing therapy and prolonged exposure in PTSD

The study found out that prolonged exposure and cognitive processing therapy were highly effective in reducing PTSD Scores.

Level III

Independent Variable: