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Part of PTSD is not wanting to think about your trauma, so most people never feel completely ready to start treatment. But if you are not able to do the things you want to do, then do not wait. Talk to your provider and discuss treatment options.
There are good treatments available for PTSD, including both psychotherapy and medication options. Trauma-focused psychotherapies, including Cognitive Processing Therapy, Prolonged Exposure, and Eye Movement Desensitization and Reprocessing (EMDR), are the most highly recommended type of PTSD treatment. Specific antidepressant medications known as SSRIs and SNRIs are also effective for PTSD.
Two of the most common psychotherapies offered at the VA are Cognitive Processing Therapy and Prolonged Exposure. All VA Medical Centers offer at least one of these psychotherapies. Many smaller VA clinics also offer these treatments. Effective medications for PTSD, including antidepressants called SSRIs and SNRIs, are widely available in VA. Many VAs also offer other services for PTSD, ranging from peer support groups to couples therapy for PTSD. The menu of PTSD treatment options varies from one VA facility to the next.
Many types of providers can deliver PTSD treatment. There are a few different ways to find a PTSD provider:
- If you have a provider you trust, ask him or her for a recommendation. You can also ask friends and family if they can recommend someone.
- If you have health insurance, call to find out which providers your insurance company will pay for.
- Search for a provider online.
- If you are enrolled in the VA, ask your VA primary care provider for a referral to speak with a mental health provider.
Learn more about Finding a Therapist on the National Center for PTSD website
Some providers may only be available during regular business hours. But more and more providers, including VA providers, are offering appointments in the evenings or on weekends. If your provider cannot meet at a time that is convenient for you, he or she may be able recommend another provider who can. If you need to take time off of work to meet with your provider, your employer may be willing to support you. In many cases, employees can use sick leave to attend PTSD treatment visits.
If you live far away from the VA, ask your provider if you are eligible for these services:
- The VA Choice Program. This program allows qualifying Veterans to receive services from providers outside of the VA.
- Video-teleconferencing. This allows patients to use a live, secure video connection to receive treatment from a provider who is at another location.
- Reimbursement for travel to and from VA appointments.
Treatment costs vary depending on the type of treatment and type of provider. Some community providers use a "sliding scale" where the amount you pay is based on your income. Others have a set price per visit. If you have insurance, check your benefits to see if there will be an out-of- pocket cost for you to receive PTSD treatment. Before scheduling your first visit with a provider, always ask about how much you will pay for each visit and when payment is due.
For information about your eligibility to get treatment at the VA and the cost of this treatment, visit VA Health Care Eligibility & Enrollment or call 1-800-827-1000.
Current research cannot tell us for sure whether receiving evidence-based psychotherapy and medication is better than doing one or the other. However, many people with PTSD choose to do both at same time.
Medications and Therapy
Learn about how psychotherapy and medications can work together.
What treatment will be like
Effective psychotherapies for PTSD usually require weekly visits for about 3-4 months. Benefits of treatment often last long after you stop meeting with a therapist. Effective medications for PTSD involve meeting with your provider every 1-3 months and taking a pill every day. PTSD symptoms may return if you stop taking the medication.
Some PTSD treatments teach you new skills. It is best to practice these skills on your own between visits. This may involve writing about your past experiences, doing an activity you have not done in a while, filling out worksheets, or listening to a recording of your treatment visit. View the PTSD Treatment Comparison Chart to learn which effective PTSD treatments involve practicing skills between sessions.
Some PTSD treatments involve talking (or writing) in detail about the trauma. This can be hard at first. But many people find that talking about the trauma in treatment helps them feel better in the long run. Talking through the trauma can help you make sense of what happened and have fewer negative thoughts about the trauma. View the PTSD Treatment Comparison Chart to learn which effective PTSD treatments involve talking about the trauma.
Some psychotherapies for PTSD (like Cognitive Processing Therapy) can be delivered in a group. Usually, treatment groups include about 5-10 people with PTSD. Group members agree not to share each other's personal information outside of the group. Group members can gain support, understanding, and encouragement from one another.
Many people want to know if they can bring a family member or friend with them to PTSD treatment sessions. In general, having friends and family who are supportive of your treatment can be very helpful. But it may not always be best for your family members to come with you to treatment sessions. Check with your provider to find out their policy about bringing someone with you to treatment. There are also different policies about whether it is OK to bring a service pet or an emotional support animal with you to treatmentso this is another good question for your provider.
How treatment can help
Some people no longer have PTSD after treatment. Others still have some PTSD symptoms, but have learned skills to cope with them better. PTSD treatment will never erase the trauma, but it can help to get rid of some or all of your PTSD symptoms.
View the PTSD Treatment Comparison Chart to see how many people no longer have PTSD after receiving effective treatment.
There are several signs treatment is helping. You may have fewer PTSD symptoms. For example, you may sleep better and feel more comfortable around people. You may also notice that you can do and enjoy some of the things that you used to do. Family and friends may start to notice a change in you, too. During treatment, your provider will keep track of changes in your PTSD symptoms by asking you questions about your symptoms or having you fill out questionnaires. This is another good way to see whether treatment is helping. Do not worry if your symptoms get a little worse before they get better. This can actually be a sign that treatment is working. But if after a few weeks things are not improving you should talk to your provider.
Sometimes people have other problems in addition to their PTSD - like depression, substance use, sleep problems, or a history of traumatic brain injury. PTSD treatment often helps with these other problems. For example, Cognitive Processing Therapy (CPT) is a type of psychotherapy that can change the negative styles of thinking that can cause both depression and PTSD. Medications like SSRIs and SNRIs are also effective for both depression and PTSD.
Problems that could come up
Most people who start PTSD treatment benefit from it. But, there's no single treatment that works perfectly for everyone. If the first PTSD treatment you try does not help, you have other effective options. You might be tempted to think that because one treatment did not work for you, no treatment can help you. But this is not the case. People who do not benefit from one treatment may find that another treatment is helpful.
What if treatment is not working?
Most people who start PTSD treatment notice that their PTSD symptoms improve. But a smaller group of people notice a slight increase in their PTSD symptoms at first. This increase is usually brief, and then symptoms get better in the long run.
Your relationship with your provider is important. If you feel comfortable with your provider, you will likely benefit more from treatment. If you have concerns about your relationship with you provider, it is important to speak up. You can start by mentioning your concerns to your provider directly. You may be able to work together to address the issue. If not, your provider may be able to refer you to another provider who is a better fit for you.
In most cases what you tell your provider during your mental health treatment visits is confidential. This means that by law, your provider cannot share this information with other people. Even if you disclose a crime, in most cases a provider typically cannot share this information. However, there are a few exceptions to this rule, for example:
- Your provider may be required to notify others if you have plans to hurt yourself or other people.
- Providers may be required to notify authorities if they learn about a situation of child abuse or elder abuse.
- In some states, providers may be required to release your treatment records if they receive a subpoena from a judge.
- Within the VA, your provider is allowed to share information about your treatment with other VA providers who are involved in your care.
These rules vary from state to state. If you are worried about sharing certain information with your provider, ask your provider to tell you exactly what would happen if you shared that type of information. You and your provider may decide it is OK for you to leave out certain details (for example, the name of another person involved, or the exact location where the event occurred) without it affecting your treatment.
Service-connected disability for PTSD is determined by the Compensation and Pension Service (C&P). C&P is an arm of VA's Veterans Benefits Administration: Compensation. This decision is not made by your PTSD provider.
People with PTSD sometimes wonder whether a provider who has not had the same experiences can actually understand them. Research tells us that people with PTSD can get better when they have a provider who has never been through a similar trauma. PTSD providers have received years of training and have experience delivering effective treatments.
Veterans often have concerns about whether a civilian provider will understand them. Here is what a few Veterans had to say about this topic:
Whether treatment can work for me
Sometimes people think that because they have had PTSD for a long time, that they will never get better. But PTSD treatment can help no matter how long you have had PTSD.
Many different types of trauma can cause PTSD, including combat, sexual assault, abuse, and disasters. Effective PTSD treatments can work for you no matter what type of trauma you experienced.
It is common to worry that if you get PTSD treatment, this could mean that another person will not get treatment or will have to wait to get treatment. If you start treatment, it does not mean that someone else will have to wait longer to get care. Many hospitals and healthcare facilities (including the VA) have a system in place where patients who need it can get immediate treatment.
You can still get PTSD treatment even if you are using drugs or alcohol. In fact, treating your PTSD symptoms may help you to gain more control over your alcohol or drug use.
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