A major focus of the National Center for PTSD's education activities is working with VA mental health practitioners in order to ensure the best possible care for Veterans who are suffering with the effects of traumatic stress.
Effective delivery of PTSD treatments can involve addressing administrative barriers. To tackle these issues within VA, the National Center for PTSD launched the VA PTSD Mentoring Program in 2008, a national network that disseminates and implements best management practices by supporting local experts in their mentoring of other VA PTSD program administrators.
Two mentors from each of the 21 VA regions, or Veterans Integrated Service Networks (VISNs), around the country work with PTSD program directors in their VISN to help them meet the increased demand for treatment by restructuring existing programs and by implementing best administrative and clinical practices. National experts are invited to join mentoring calls each month, to inform mentors of innovative practices and administrative structures and consult with them on how to maximize efficient and cost-effective care.
In FY2011, the Program was able to hold a face-to-face conference. Presentations focused on how to redesign clinics to increase the delivery of services to Veterans as well as how to collect, organize and present clinic data.
The monthly PTSD psychopharmacology lecture series launched through the Mentoring Program has evolved into a monthly webinar series on the 2010 VA/ Department of Defense (DoD) PTSD Clinical Practice Guideline for Management of Posttraumatic Stress.
In February 2011, National Center for PTSD launched a PTSD Consultation Program to allow VA providers to schedule a consult with PTSD experts. The program is offered free to all VA clinicians treating patients with PTSD to assist them with providing the best PTSD care. VA clinicians and providers can speak directly with staff psychologists and physicians about: treatment, clinical practice, resources for PTSD treatment, improving care for PTSD patients, assessment questions and programmatic issue. To date, over 80% of consults have been to providers who are not based in PTSD Specialty Care. A national lecture series in a Grand Rounds format was started in January 2012 and highlights issues posed by providers.
Prolonged Exposure and Cognitive Processing Therapy. Initiated in fiscal year (FY) 2007 at the direction of the VA Office of Mental Health Services (OMHS), the rollouts of two evidence-based therapies for PTSD, Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) continued to be a highlight of the National Center for PTSD's educational endeavors in FY 2011. Over the past few years, both programs have created extensive trainings and support materials including manuals, videos, and CD-ROMs. Additionally, both programs now have processes in place to certify both clinicians and trainers. In a new effort to de-centralize the dissemination of the therapies local experts are being trained as trainers and consultants.
To date, 1,333 clinicians have participated in the 4-day PE trainings along with 16 trainers and 70 consultants. Outcomes of PE measured during training cases continued to show a clinically-significant mean reduction of 20 points on the PTSD Checklist. Over 5,900 VA and military clinicians have been trained in CPT. There are now 29 VISN-level trainers, 8 Department of Defense trainers, and 11 Rehabilitation Counseling Services (Veteran Center) trainers in addition to 14 National Roll-out level Trainers. An online "refresher" enrichment course for CPT trained practitioners has just been released.
Acceptance and Commitment Therapy. The National Center for PTSD collaborated with the Sierra-Pacific MIRECC and Office of Mental Health Services to continue national implementation of Acceptance and Commitment Therapy (ACT) for depression (a mental health problem that is highly co-morbid with PTSD) and co-occurring anxiety. During the last fiscal year, five 3-day workshops were held with 182 trainees in attendance.
Smoking Cessation Learning Collaborative (SCLC). The purpose of this initiative is to apply the Learning Collaborative Model in six selected Veteran Integrated Service Networks (VISNs) to foster the successful implementation and sustained use of Integrated Smoking Cessation Care (ISCC), an evidence-based intervention that integrates smoking cessation treatment into mental health care for PTSD. The ISCC was successfully implemented by the delivery of integrated care by 46 providers to 175 Veterans, with 34% Veterans reporting abstinence at one time point. A larger collaborative is currently being planned with support from the Office of Mental Health Services (OMHS).
Clinical Training Program. From 1990 - 2012, the National Center for PTSD's Dissemination and Training Division has held 9 week-long training seminars on the assessment and treatment of PTSD. During FY 2011, 112 mental health providers attended the Clinical Training Program (CTP), including 67 VHA, 12 Department of Defense, 6 Veteran Center, and 27 other practitioners. The CTP offered attendees opportunities for both "classroom-style" and group observation learning experiences during the week-long curriculum, with a focus on take-home skills designed to improve Veteran care.
Due to a re-vamp of the program, we are unable to provide information about this training program and its logistics at this time.
Other Trainings. The Dissemination and Training Division co-sponsored the Annual Updates on PTSD day-long CEU conference with the Sierra-Pacific (VISN 21) MIRECC. Over 100 mental health clinicians in VISN 21 learned about PTSD and the family and developers of VA family programs presented their work. The Pacific Islands Division, as in previous years, organized a one-day International Violence and Trauma National Center for PTSD Pre-Conference Training on Under-Emphasized Aspects of Trauma Treatment.
The National Center for PTSD continues to work with the Office of Emergency Services and OMHS to support VA's disaster mental health response. We created two mental health-related online training programs, one on self-care and one on Psychological First Aid. Workshops on the role of social support in Federal Medical Stations were provided for over three hundred VHA and Medical Reserve Corps trainees at the 2011 National Disaster Field Training in Alexandria, LA.
In addition, a Disaster Mental Health Toolkit was designed to assist VA staff who are seeking to volunteer to provide mental health support during disasters. Guidelines for participating and information about the VA's role in disaster are provided.