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Research improves treatment outcomes for veterans

Research, Veterans

Research and trials are an important part of Phoenix Australia and the Anzac Centre.

Worldwide, researchers are looking for new ways to help veterans who experience posttraumatic stress disorder (PTSD). From finding ways to reduce the risk of PTSD developing, to testing more effective ways of lessening and managing its effects, Phoenix Australia and the Anzac Centre are playing a leading role.

A number of trials and research projects are underway at Phoenix Australia, while previous projects have helped to shape PTSD treatments on a national and international level. Dr Tracey Varker, a Senior Research Fellow at Phoenix Australia, spoke about a number of these research trials.

“One of the biggest trials we are currently conducting is the RESTORE trial that began a few years ago and is still recruiting participants. In this trial the research team headed by Dr Lisa Dell is looking at different ways in which prolonged exposure treatment, an evidence-based treatment for PTSD, is delivered. Normally the treatment is delivered in 90-minute sessions once a week over 10 weeks. RESTORE is looking at whether the 10 sessions can be carried out in the space of 10 working days,” explains Dr Varker.

Prolonged exposure therapy is a gold standard evidence-based treatment for PTSD, but Dr Varker says it can be difficult for people to attend sessions over a 10-week period.

“Feedback from researchers and clinicians was that if you could get people doing the sessions in one block, it would be easier and make the treatment more accessible. The research question is looking at whether having the treatment once a week over an extended period of time, or daily in a more intense dose, has the same effect.”

The SOAR (Stepping Out: Attention Reset) trial is another trial currently underway at Phoenix Australia, testing an attention training task to see whether it can help transitioning Defence force members with readjustment to civilian life and to reduce or prevent mental health problems. The attention training is like a simple computer game. It involves looking at simple words flashed on a screen and responding to them. Some will be ‘threat’ words and others ‘neutral’ words and the idea is, through repetition, to potentially re-balance attention from being either significantly over-engaged or completely disengaged from potential threat in the environment or elsewhere.

“The aim of the trial is to look at whether we can dial down levels of hyperarousal or feelings of being on guard as the veteran returns to civilian life,” says Dr Varker.

“We know the transition phase can be particularly difficult, and evidence has come from the Israeli defence force and the US which have used this technique, that we can potentially bring down heightened attention, and make the transition a little easier”.

“It’s a simple, cost-effective intervention that, if shown to work, could be given to every person exiting the military, and it has the potential to improve their mental health outcomes and PTSD symptoms down the track. It could have quite a significant impact.”

Dr Varker says conducting trials is important because while there are good evidence-based treatments for PTSD, those treatments don’t work for everyone.

“Amongst veterans in particular, around a third do well and two thirds have residual symptoms or stay the same, so we need to get more sophisticated in the therapies we use. It’s not one size fits all,” she explains.

“Some people may have tried traditional therapies, like prolonged exposure or trauma-focussed cognitive behavioural therapy, and they are in the third of people who don’t respond. They are ‘treatment resistant’, so what happens to those people? We need to try and keep building on what we know, create more options for therapies, and find ways to make treatment more accessible.”

Research and trials are also important to support health practitioners working with military personnel and veterans. Information overload and trying to keep up-to-date with the latest knowledge while running a busy practice, can be difficult. Research and trials help identify useful information for practitioners.

“At Phoenix Australia, our research, policy and practice arm, and training department all speak to each other,” says Dr Varker.

“We think about approaches that will work in real life and that will translate to support practitioners as they support veterans.”

 

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