Patricia A. Resick, Ph.D.; VA Boston Healthcare System, PTSD Mulitdisciplinary Research Consortium Award

The military problem that I am connecting research on is the treatment of post traumatic stress disorder. This study is a unique opportunity to do a one-site study, a large study to compare group and individual cognitive processing therapy.

Cognitive processing therapy can be done either as an individual therapy or in a group format with perhaps eight to ten people. It was originally developed as a group therapy but has been very difficult to study because normally you don't have the populations in one place that you could do this kind of research. So the first year of the project we will be comparing group cognitive processing therapy with a present-centered therapy so two different kinds of group therapy.

And then after that we will be comparing group cognitive processing therapy with individual cognitive processing therapies. The question is whether both of these are equivalent. We've done them in both of these formats but the research has never been done. So we don't know if group works as well as individual or if it works better; they both have advantages and disadvantages.

This is a big public policy question as well because if it turns out that group cognitive processing therapy works well then it's more cost-effective to have group therapy, you know, because you can have 10-one therapist and 10 patients being seen at the same time.

If it turns out it doesn't work as well as individual therapy, then we have to put the investment in having enough therapists to treat everyone who has PTSD in an individual setting.

We're in the pilot phase right now. We've been doing pilot cases and so forth but I don't think there's going to be any problem with the recruitment for this study over the next 3 years. We will be starting the main data collection this fall.

Prior to this project, I've had 30 years of working on this therapy but not in an active military setting. I started working at the University of Missouri, St. Louis; I was working with rape victims and battered women 30 years ago. And in the process, I developed cognitive processing therapy in 1988. And then tested it with-primarily with rape victims; then we moved onto testing it with battered women, child sexual abuse. We've had one study in the VA with veterans, primarily Vietnam Veterans. It's now being rolled out throughout the entire VA system so we've been training therapists all over the country to do this therapy and we now have effectiveness data from some of the hospitals showing that it's working that it's reducing their PTSD symptoms in a very short period of time-12 sessions.

One of the difficulties whether you're doing research is practice is that there's still a perceived stigma about getting treatment for post traumatic stress disorder. Very often soldiers are unwilling to get treatment because they're afraid it's going to hurt their security clearance or they're afraid it's going to hurt their career in some way, which is not the case. The rules have been changed; I think people in the military have tried very hard to destigmatize receiving treatment but I think getting the word out is always a tough piece. And I think when people realize they can get treatment, and they can improve and get better, the word will then spread.

We would love to have soldiers step forward particularly at Fort Hood-to be involved in this study because this is where that study is going to be conducted. They're not just helping themselves; they're helping other soldiers by participating in research and I think that's one of the important things that I think people realize is that they're getting two things for their participation. One is they're helping themselves; second, they're advancing treatment and treatment options for everyone who follows them.

This study is part of the Strong Star Consortium. It's one of a number of studies; this is actually the largest study that will be conducted in that-as part of that consortium. We're hoping to conduct the therapy with 500 soldiers with PTSD.

It's my first experience working in a consortium. It's really been rather amazing. It's such an amazing collection of great minds, and there's such a sense that you've got this team behind you that are helping every step of the way. It's a lot to navigate and we have some really wonderful researchers working there with us. Great statisticians, they're setting up databases; I mean at every point you've got a giant team behind you as opposed to you, the lone researcher trying to work things out yourself. It's been wonderful.