Australian-first trial offers faster treatment for PTSD
An Australian-first research program will help improve treatment for military personnel and veterans with posttraumatic stress disorder (PTSD).
Phoenix Australia – Centre for Posttraumatic Mental Health at the University of Melbourne – is leading the trial of an intensive treatment program with current and former Australian Defence Force (ADF) members who have PTSD. The National Health and Medical Research Council (NHMRC) awarded a partnership grant to conduct the RESTORE trial to the Departments of Veterans’ Affairs, the Department of Defence, and Phoenix Australia.
The trial will assess whether delivering PTSD treatment over an intensive, two-week period provides equal or better mental health outcomes than current treatments that involve therapy over ten weeks.
PTSD is a common and often severe problem. Over one million Australians a year suffer from PTSD, and current and ex-serving military personnel are affected at higher rates than the general community. PTSD symptoms include reliving the traumatic event through unwanted memories, nightmares, or flashbacks; feeling wound up - having trouble sleeping or concentrating, feeling angry or irritable, or constantly on the lookout for danger; avoiding reminders of the event; and feeling afraid, angry, guilty or numb. People experiencing PTSD may lose interest in their day-to-day activities, and feel cut off from their family and friends. Although PTSD is a serious condition which can cause high levels of distress, as well as problems in relationships and a reduced ability to work, there are excellent treatments available.
One of the most effective treatments for PTSD is prolonged exposure therapy (PE). PE involves weekly treatment in a safe and supportive environment with a therapist guiding and supporting the person to work through specific traumatic events. Over the course of the treatment, reactions to the memories of these events become less intense. PE has been implemented across veteran and military clinical settings in the USA and has been found to be helpful for veterans with PTSD. The treatment is typically delivered once weekly for 10 weeks, a duration that can pose a barrier to serving members and veterans - deployments, training exercises, family, work and life commitments can make a 10 week time period challenging for many to commit to.
The Rapid Exposure Supporting Trauma Recovery (RESTORE) trial will assess whether an intensive form of PE therapy, involving 10 sessions over two weeks, is as effective as the standard 10 weeks of weekly PE. Intensive treatments have been found to be effective for a range of other mental health conditions and preliminary research for PTSD suggests its potential effectiveness for PTSD also. If people experiencing PTSD can obtain the same benefits in two weeks of PE as in 10 weeks, it may make the treatment more accessible to those who need it.
The RESTORE trial has commenced and will recruit 200 current and former ADF members between the ages of 18 and 70 across three states – Victoria, New South Wales and Queensland. Participants must be experiencing symptoms that are consistent with PTSD and related to a traumatic experience during their military service. Participants are interviewed and randomly allocated to attend eitherdaily therapy sessions for two weeksor weekly sessions for 10 weeks. The trial will be conducted at Phoenix Australia in Melbourne, the Veterans and Veterans Families Counselling Service (VVCS) offices in Melbourne, Brisbane and Sydney, and the ADF Centre for Mental Health in Sydney.
Potential benefits to participants are an improvement in their PTSD symptoms and a better quality of life. If the study shows intensive PE to be as effective as weekly PE, the treatment may be built into existing services for current serving members and veterans across DVA, VVCS and the ADF, providing access to the treatment for those who need it.
Chief investigator, Professor David Forbes, describes PTSD as “the most prevalent mental health disorder among Defence personnel. Within the broader community, more than one million Australians a year have PTSD. Even the best treatments available are not a solution for everyone. We need to develop and test new and innovative approaches to help those not benefitting from current approaches. The outcomes of this trial will help not just the military and veteran community, but also other Australians with PTSD as we improve PTSD treatments for everyone.”
The first person in Australia to receive the new form of PE in a pilot of the study had experienced worsening symptoms over sixteen years from his experiences on deployment: “I hit rock bottom … all I thought about was death … I was drinking pretty heavily; angry all the time … and having many nightmares.” He credits his wife, who researched PTSD and found out about the RESTORE trial, with preventing him from being “just another military veteran suicide statistic”. At the end of treatment, he stated, “I got my life back, maybe not the same one that I had before, but it is one that I will cherish and enjoy to the fullest every day that I can.”
Any veterans or serving members interested in participating or referring someone to the trial can call the centralised RESTORE intake number 1800 856 824 or visit www.phoenixaustralia.org/RESTORE.