Common Challenges in Conducting Prolonged Exposure Therapy With Active Duty Service Members: Case Discussion and Strategies for Intervention |
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Authors: | Brooke Fina Edward C Wright Tracey K Lichner Adam Borah Edna B Foa for the STRONG STAR CONSORTIUM |
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Institution: | 1. Division of Behavioral Medicine, Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USAFina@uthscsa.edu;3. Division of Behavioral Medicine, Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA;4. Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, Pennsylvania, USA;5. Carl R. Darnall Army Medical Center, Fort Hood, Texas, USA |
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Abstract: | Prolonged Exposure (PE) Therapy receives most of its empirical support from trials conducted with civilian posttraumatic stress disorder (PTSD) populations. There has been only limited research on its use with military personnel with combat-related PTSD, and as a consequence, there has been less clinical discussion detailing its application with active duty service members. The purpose of this paper is to highlight two challenges that commonly arise when conducting PE with active duty service members: 1) selecting the most appropriate index event to focus on in imaginal exposure out of the numerous traumas an active duty patient is likely to have experienced, and 2) patients’ tendency to engage in “safety behaviors,” which undermine the effectiveness of in vivo exposure. The nature of these challenges is explored from a theoretical perspective, along with two case examples to illustrate their presentation in treatment. Specific strategies for addressing them are reviewed. |
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Keywords: | PTSD cognitive behavioral therapy Prolonged Exposure therapy case study mental health military |
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