Advances in the Treatment of Posttraumatic Stress Disorder: Cognitive-Behavioral Perspectives

Mark Creamer and David Forbes

The development of mental health problems, particularly posttraumatic stress disorder (PTSD) and related conditions, is a major issue for defense forces around the world, with serious implications for operational performance, readiness to deploy, retention rates, and compensation. Although little adequately controlled treatment research exists with the military population, there is evidence to suggest that cognitive-behavioral treatments for military-related PTSD may be beneficial, albeit perhaps less so than for some other populations. This chapter commences with some contextual information designed to assist clinicians in formulating such cases and in understanding some of the complexities relevant to the treatment of PTSD in this population. The chapter goes on to provide a brief review of literature on cognitive-behavioral therapy (CBT) outcome research with military populations, before discussing specific aspects of treatment and foreshadowing future directions.

Although the focus is usually on post-deployment mental health, it is important to emphasize that much PTSD in military populations may result not from deployments but from other non-operational traumatic events. These may include motor vehicles and training accidents, as well as physical and sexual assaults. The prevalence of psychiatric problems following such events has been well documented in civilian populations (see, for example, Creamer, Burgess, & McFarlane, 2001; Kessler, Sonnega,

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