Evidenced Based Psychotherapy - Milwaukee VA Medical Center
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Milwaukee VA Medical Center

 

Evidenced Based Psychotherapy


What is evidence-based psychotherapy (EBP)?
It is empirically validated, research-based psychotherapy treatments that have been demonstrated to work with particular disorders. Within the VA there are several EBPs that have been recommended for the treatment of post-traumatic stress disorder, depression, anxiety, serious mental illness and substance abuse. There has been a national effort to send mental health treatment providers to be trained and become certified in these EBPs.

Why is this the best type of care?
EBPs provide consistency of interventions across the VA sites as research data shows them to be very effective because they tend to be efficient and are time-limited. Research also shows this treatment reduces overuse of behavioral health resources, as patients, overall see diminishing gains with long-term therapy. Our goal is to treat Veterans and get them fully healthy, based on the best scientific evidence. This is much more effective than creating an atmosphere where the Veteran remains in consistent treatment and doesn’t get better.

What type of evidence do you have to back up that this works?
Research conducted within the VA has shown the evidence-based psychotherapies to be effective in reducing the symptoms of PTSD, depression and anxiety.

How come other places in community offer more hands-on, around-the-clock care? That sounds to me like it would be a lot more beneficial.
There certainly is a benefit to having immediate access to care. The VA provides this with the Mental Health Urgent Care Clinic where veterans can be seen on an emergency basis. There are also several drop-in therapy/support groups held during the week for which veterans do not need appointments to attend. For information on these groups, please call 414-384-2000, ext. 46012, for group types and times. The Impressions Group is a weekly drop in group for all veterans looking for additional MH support. It meets in room 8229 from 11:00 a.m. to 12:00 p.m. No appointment necessary. We encourage Veterans to find the treatment that works best for them, but it’s important that treatments don’t conflict. Current research and evidence shows patients receive the most benefit when they are enrolled in a time-limited and effective treatment plan. We offer many comprehensive programs to make that happen. Our treatment is based on the best scientific evidence, and the health of our Veterans is our top priority.

Does this mean you guys are just going to give me a bunch of drugs?
Actually, the recent rollout of EBPs is geared toward the provision of psychotherapy, not medication.  Medications may also be an effective component of your treatment prescribed by your provider. Psychotherapy would include many options. We offer the following Evidence-Based Psychotherapies: 

Behavioral Family Therapy – (BFT)
BFT is for veterans with SMI and their key supporters. Therapy sessions are focused on family education, communication, and problem-solving skills.

18-20 Week sessions

Cognitive Behavioral Therapy – (CBT-D)This therapy focuses on relationships among thoughts, feelings, and behaviors with the goal of improving mood. It helps patients learn new patterns of thinking and to develop new positive behaviors.

16 weekly sessions

Interpersonal Therapy – (IPT)
This therapy focuses on promoting positive relationships and resolving relationship problems due to life changes, relationship conflicts,loss, or other issues.

16 weekly sessions

Prolonged Exposure therapy - (PE)
PE focuses on decreasing avoidance of trauma triggers and negative emotions through in-vivo (real-world) exposures and talking through the trauma memory.

8-15 weekly sessions

Refer to additional brochures on CPT and PE for more information

Cognitive Behavioral Therapy for Insomnia - (CBT-I)
CBT-I focuses on changing thoughts and behaviors to help with difficulties falling and staying asleep as well as increasing restful sleep.

6 individual or group sessions

Problem Solving Training – (PST)
The goal of PST is effective application of positive problem-solving attitudes and behaviors to cope with stress. PST enhances optimism, improves emotion regulation, and flexibility in matching effective strategies to stressful situations

4-6 individual or group sessions

Social Skills Training – (SST)
SST aims to improve skills in health maintenance, assertiveness, conflict management, work, and relationships.
Session role-plays are used to assist in practicing skills.

2-3 group sessions per week or individual sessions

Acceptance & Commitment Therapy - (ACT)
ACT focuses on managing thoughts and feelings that overwhelm our sense of well-being. It helps patients overcome struggles with emotional pain and recognize and commit to what matters most in their lives.

12-16 weekly sessions

Cognitive Processing Therapy - (CPT)
CPT focuses on the relationship between thoughts and emotions. Patients work through “stuck” points related to trauma. Trauma-related beliefs are explored as well as issues related to safety, power, control, trust, intimacy, and self-esteem.

12 weekly sessions
Individual or group therapy

Cognitive Behavioral Therapy for Chronic Pain - (CBT-CP)
This therapy focuses on changing thoughts and behaviors to help improve pain management and quality of life.

9-12 weekly sessions

Cognitive Behavioral Therapy for Chronic Pain - (CBT-CP)
This therapy focuses on changing thoughts and behaviors to help improve pain management and quality of life.

9-12 weekly sessions

Integrative Behavioral Couples Therapy – (IBCT)
This therapy promotes acceptance and tolerance of spousal differences. IBCT incorporates negotiation strategies with behavioral change goals.

20 weekly couples sessions

What if I don’t want to take all the medications you prescribe?
We want our Veterans to be involved in their treatment plan! Please share your concerns with your psychiatrist or nurse practitioner so you can both create a treatment plan that best meets your needs.

What are the dangers of any medicine you prescribe?
Medication side effects can be discussed with your prescribing provider and/or the pharmacist.

When did you switch to this standard of care?
In 2009, there was the creation of the role of a local EBP coordinator in each VA. The coordinator’s role is to provide information about the EBP rollout s and facilitate getting staff trained in the various EBPs.

Is there any evidence to suggest this type of care is more successful?
Yes! Long-term research shows that often optimal benefit from psychotherapy can be achieved within four months.

It took me a lot longer to get in this condition. How do you plan on helping me in this short amount of time?
The EBPs are time-limited and really keep the focus on reducing the symptoms that are problematic. Your health is of primary importance to us. There are times during treatment where care will be extended if it’s in the best interest of the Veteran. We have many success stories with this standard of practice, and are here to help you. You served your country and we want to serve you. Sometimes the first, best step to getting better is coming to us for help, and having an open mind.

I have PTSD and substance abuse issues. Will I be able to stay longer to treat both conditions?
Yes. Sometimes the reduction or elimination of troubling symptoms can create the opportunity to then focus on changing other difficulties that are making one’s life unmanageable. We will work with you to come up with the best course of treatment.

I have a family member I think is struggling and needs help. Any advice on how I can convince this person to get care?

You can let them know they are not alone and other Veterans have similar problems. You can offer to accompany them to their first session.

What is the best way to be successful in one of these programs?
The best way to be successful is to attend all sessions, communicate with your therapist and do the homework. Practicing the new skills between sessions allows you to come back and share what works and doesn’t work with your therapist.