On August 29th, the Department of Veterans Affairs' (VA) National Center for Posttraumatic Stress Disorder (PTSD) celebrated its 25th anniversary. For the past 25 years, the Center has been the leader in research and education helping those who are living with PTSD.
The proposal for creating a National Center for PTSD arose from the growing mental health needs of Vietnam Veterans and others, and the recognition in 1980 of the PTSD diagnosis by the American Psychiatric Association. In 1984 Congress directed VA to form a National Center for PTSD "to carry out and promote the training of health-care and related personnel in, and research into, the causes and diagnosis of PTSD and the treatment of Veterans for PTSD."
VA established the Center in 1989 as a center of excellence that would set the agenda for research and education on PTSD. Although initially organized as a consortium of five divisions, the Center now consists of seven divisions across the United States, with headquarters in White River Junction, VT. Other divisions are located in Boston, MA, West Haven, CT, Palo Alto, CA, and Honolulu, HI. Each contributes to the overall Center mission through specific areas of focus.
"When we started, PTSD was a controversial diagnosis," said Dr. Matthew Friedman, the Center's Senior Advisor and its Executive Director from 1989 through 2013. Our research and educational initiatives helped establish the scientific basis for PTSD, and disseminated that information globally."
From the very beginning, the Center's initiatives have been making a critical difference in the understanding, assessment and treatment of PTSD.
Assessment and diagnosis. The Center's first meeting in 1989 launched the development of the Clinician-Administered PTSD Scale, the CAPS, which became the gold standard for assessing PTSD. Since then we have developed other leading assessment measures for trauma and PTSD for use in VA, the Department of Defense, and around the world. These assessment measures have advanced the clinical care of Veterans living with PTSD and research on PTSD by ensuring accurate diagnosis and assessment.
Applying technology to educate and disseminate information about PTSD. In 1991, our Published International Literature on Traumatic Stress database (PILOTS) became available to the public, providing a comprehensive cross-discipline index to all published research on trauma. In 1995, the Center launched its website, www.ptsd.va.gov, which has since become one of the world's leading websites on PTSD.
The Center has become the leader in online PTSD continuing education and technology-based education and resources for trauma survivors. In 2011 the Center partnered with the Department of Defense for the first publicly available VA mobile app, the award-winning PTSD Coach. Other self-help and treatment companion apps followed, as did an expanded desktop version of the Coach app, PTSD Coach Online. AboutFace, an online video gallery of Veterans talking about living with PTSD and how treatment has turned their lives around, breaks down barriers to seeking care and misconceptions about PTSD and its treatment. We continue to use technology to expand our reach, recently releasing our first YouTube Whiteboard video What is PTSD?.
Research, training and provider support. The National Center for PTSD also improves care of Veterans and others through its research into the prevention, causes, assessment, and treatment of traumatic stress disorders. Our investigators have been at the forefront of research demonstrating alterations in brain function associated with PTSD, which has significantly enhanced the science and understanding of PTSD and improved PTSD identification and care. They have also conducted leading research on the treatment of PTSD, particularly the main evidence-based psychotherapies: Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE).
Our staff assisted VA with national clinical training programs in these therapies, helping make available state of the art treatment for PTSD to Veterans across the country. To support evidence-based PTSD care, in 2008 the Center helped create the VA Mentoring Program, which encourages implementation of evidence-based treatments for PTSD , and in 2011 helped establish the VA PTSD Consultation Program, which advises VA clinicians on PTSD.
As Elana Newman and Bruce Shapiro wrote in the International Society for Traumatic Stress Studies' (ISTSS) newsletter on our 20th anniversary, "The Center has clearly advanced science and promoted understanding of traumatic stress in ways that the Senators who envisioned the Center never imagined would be realized. In fact, much of the knowledge we have about PTSD at this point has been generated and disseminated through the efforts of the National Center staff. The Center has sparked changes in the field that have fostered general understanding of PTSD as well as translated into concrete benefits for survivors of trauma, the VA/DoD system, and family members."
While the Center has made great strides in PTSD research and education over the past 25 years, we look forward to making even greater progress in prevention, resilience and recovery as well as diagnosis and treatment. We have many exciting initiatives in progress.
For example, the National Center for PTSD is creating the nation's first brain tissue repository, or brain bank, dedicated to researching the physical impact of stress, trauma and PTSD on brain tissue. The administration of the Brain Bank has been organized, and its construction is well under way.
Last year President Obama announced the award of $45 million over five years to the Consortium to Alleviate PTSD (CAP), co-led by the Center, to advance PTSD diagnosis, prevention and treatment for service members and Veterans. CAP will research the biology/physiology of PTSD development and treatment response to inform diagnosis, prediction of disease outcome, and new or improved treatment methods.
Dr. Paula Schnurr, the Center's Acting Executive Director, is lead principal investigator in a $10 million groundbreaking study that will compare the two major evidence-based psychotherapies for PTSD: Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE). The study's results will help inform choices about the delivery of PTSD care in VA, and will also be broadly relevant to the scientific and clinical communities outside VA.
"We have come a long way in the past 25 years, but there remains much more to be done," said Dr. Schnurr. "We must continue to increase our scientific understanding of PTSD through research and develop better evidence-based treatments as well as prevention strategies. We also need to raise public awareness of PTSD and help people with this mental health problem get the care they need. I am confident that we can and will meet these challenges."
For more information about the Center's accomplishments, history, and future projects, visit our 25th Anniversary Celebration page.