Sheila Rauch, PhD: Using Evidence-Based Treatments and Interventions to Help People with PTSD

Barbara Rothbaum is the director of our program at the Emory Healthcare Veterans Program. She hired me to set it up because I’ve set up lots of programs for post-9/11 veterans, mental health services. I’m very data driven. So, every decision we’re making is based on the data from the past and what we know works, what we think may work best, and then collecting data all along the way to inform is this working, how can we make this work better, who are we serving, who are we not serving, how can we get the access better, you know, all of those questions. So, for the past I think it’s six years now, 2015 ’til now, we’ve basically been doing that. So, learning from every step of the way, how to hit the problems that they’re having, so broadening out from kind of the traditional, more specific, PTSD idea to including a broader sense of more post-traumatic stress that a lot of our service members have, and then being able to look more and more at how can we address these co-morbid conditions that are coming in. A good example of how we’ve changed it is substance abuse. So, we started off where substance abuse was an exclusion criterion, and that was the single most common reason why someone wasn’t eligible to come into our program. So, we said “wait a minute, how can we serve this group, and really get them access to good care?”. So, we developed a substance use track in our program that works well, that fits in the same time period, and that we’re getting outstanding outcomes. So, now we’re able to serve that 40 percent of people that we were doing intakes on who weren’t eligible because of that substance use disorder. I would say the biggest thing for the field to learn from what we’ve been doing at the Emory Healthcare Veterans Program is really how important it is to start with the effective interventions that have shown outcomes in clinical trials, take those and start using them clinically, and trying to stay as close to the model from the studies as we can because it tends to work really well. We provide flexibility to the individual, but we’re sticking to the models of what we know work, and we’re really looking at the research on mechanisms of how these treatments work in the brain and the body, and when we’re making modifications, we’re doing things consistent with that. We’re collecting the data so that we can say “Did this work the way we thought it would? Did it not work? What do we need to do next time to make it work better, how can we take what we’ve learned and apply this to additional patients?” And I think the single most important thing I have to say to all of the community is PTSD is a treatable disorder. We have outstanding evidence-based treatments like prolonged exposure and cognitive processing therapy. Starting there is the best thing that we can do for our patients with PTSD. And then adding the other stuff after we see where those take us is a very efficient and effective way to provide treatment to this complex population. BrainLine is powered in part by Wounded Warrior Project to honor and empower post-9/11 injured service members, veterans, and their families.