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Here at VA Black Hills Health Care System, we realize that not all wounds are visible, and our Mental Health Program provides consultation, evaluation, and treatment for a variety of issues that can impact the emotional well-being and behavior of our Veterans and their families.

Veterans of all eras and both sexes can be affected by military trauma. We offer both residential and outpatient programs. 

PTSD Symptoms

Key Symptoms of Post Traumatic Stress

Re-Experiencing the Traumatic Event

  • Intrusive, distressing recollections of the event
  • Flashbacks (feeling as if the event were recurring while awake)
  • Nightmares (the event or other frightening images recur frequently in dreams)
  • Exaggerated emotional and physical reactions to triggers that remind the person of the event
  • Avoidance of activities, places, thoughts, feelings, or conversations related to the trauma

Emotional Numbing

  • Loss of interest
  • Feeling detached from others
  • Restricted emotions

Increased arousal

  • Difficulty sleeping
  • Irritability or outbursts of anger
  • Difficulty concentrating
  • Hyper-vigilance
  • Exaggerated startle response

Other possible signs of PTSD

  • Sleeping difficulties
  • Unwanted memories
  • Jumpiness
  • Depression and guilt
  • Irritability and anger
  • Difficulty concentrating
  • Unsuccessful relationships
  • Desires to numb feelings
  • Alcohol and/or drug use
  • Isolation
  • Anger
  • Suicidal feelings & thoughts
  • Anxiety
  • Nervousness
  • Denial
  • Emotional Constriction
  • Substance abuse
  • Intrusive thoughts

Who is likely to suffer from PTSD?

Anyone who experiences or witnesses a traumatic event is likely to suffer from PTSD. PTSD can affect survivors of events such as war, violent attacks, rape, motor vehicle accidents, natural disasters, child abuse, suicide, or murder.

What is Post Traumatic Stress?

Post Traumatic Stress is a serious condition that can develop after a person has experienced or witnessed a traumatic or terrifying event in which there was serious physical harm or threat. PTSD is a lasting consequence of traumatic ordeals that cause intense fear, helplessness, or horror. Examples of things that can bring on PTSD include sexual or physical assault, the unexpected death of a loved one, an accident, war, or natural disaster. Families of victims can develop PTSD, as can emergency personnel and rescue workers.

Who is likely to suffer from PTSD?

Anyone who experiences or witnesses a traumatic event is likely to suffer from PTSD. PTSD can affect survivors of events such as war, violent attacks, rape, motor vehicle accidents, natural disasters, child abuse, suicide, or murder.

Post Traumatic Stress Outpatient Program

PCT: Post Traumatic Care Clinical Team

(Formerly SUPT: Substance Use/Post Traumatic Stress Disorder Program)

Not all wounds are invisible.

Trauma can influence your behavior in several ways:

  • sleeping difficulties
  • unwanted memories
  • jumpiness
  • depression and guilt
  • irritability and anger
  • difficulty concentrating
  • unsuccessful relationships
  • desires to numb feeling
  • alcohol or drug use
  • and others

The Post Traumatic Stress Disorder Outpatient Program (PCT) at the Fort Meade Campus of the Black Hills Health Care System works with Veteran's of all eras, suffering the effects of traumatic military and/or civilian experiences.

What is PCT?

The Post Traumatic Stress Treatment program was established to address symptoms of delayed stress related to civilian and military traumatic experiences (combat and non-combat). The PCT Staff takes a holistic  approach to treatment and addresses psychological, physical, social and spiritual issues related to Post Traumatic Stress Disorder. Various treatment modalities include group, individual and family therapy to address PTSD symptoms and if needed substance abuse problems.

Medications can help reduce or alleviate many symptoms of PTSD. The PCT Prescribers educate Veterans about the medical treatment of PTSD symptoms.

Adjunct services are provided that support the Veteran’s daily life. The PCT program incorporates services for the significant others in the Vet’s life, as well as addressing recreational and spiritual needs of the veteran.

Who is eligible for PCT/SUPT?

Any Veteran is encouraged to contact us directly or may be referred by his/her current provider. Common referral sources include Veteran Outreach Centers, Veteran support groups, lay and religious counselors, and substance abuse treatment facilities.

What is PCT treatment like?

Soon after a referral is received, a face-to-face appointment with the veteran will be arranged. During this appointment the Veteran is oriented to the diagnosis of PTSD and current treatment options are discussed. PCT services focuses on a strength’s recovery model of care. Treatment emphasis is on the inherent potential for human growth in each veteran’s life. Staff and fellow veterans support each veteran in their search for healing, meaning and wholeness, even in the midst of struggle and adversity.

Evidenced-based Therapy

Evidenced-based therapies used to treat Veterans who have a diagnosis of PTSD

Cognitive Processing Therapy (CPT) 
Cognitive Processing Therapy (CPT) helps you by giving you a new way to handle these distressing thoughts and to gain an understanding of these events. By using the skills learned in this therapy, you can learn why recovery from traumatic events has been hard for you. CPT helps you learn how going through a trauma changed the way you look at the world, yourself, and others. The way we think and look at things directly affects how we feel and act.

Prolonged Exposure (PE) 
Exposure therapy is a type of therapy that helps you decrease distress about your trauma. This therapy works by helping you approach trauma-related thoughts, feelings, and situations that you have been avoiding due to the distress they cause. Repeated exposure to these thoughts, feelings, and situations helps reduce the power they have to cause distress.

Virtual Reality (VR) 
Virtual Reality therapy immerses a veteran in a computer-generated world that simulates the environments in which many combat-related traumas occur. By revisiting the traumatic event in a sensory-rich environment, veterans may experience better activation of the traumatic memory and improved emotional engagement. By repeated exposure to the memory, anxiety and related symptoms may reduce over time.

Adjunct Therapies

Biofeedback can help veterans learn how their bodies react to stressors that affect the autonomic nervous system and trigger the “fight or flight” responses seen in those with PTSD. The ultimate goal of biofeedback therapy is to allow individuals to increase their awareness about what happens to their body when under stress and feeling anxious. This can allow for the development of coping tools that bring stress and anxiety under control.

Cognitive Behavioral Therapy for Insomnia
Sleep disturbance, one of the most widely reported symptoms after psychological trauma.  Using CBT for insomnia, we can explore thinking patterns and behaviors to find the roots of your insomnia problems and resolve issues that continue to cause you distress

ISTEP Groups
Is a psycho-educational group that reviews CPT concepts and continues to examine how
trauma impacted your beliefs about yourself, others and the world in the following areas:
safety, trust, power/control, esteem and intimacy.

Skills based, Strengths Approach and Recovery oriented groups
The Strengths Approach does not focus primarily on symptoms, problems or diagnoses, but looks at each veteran more holistically and focuses on and amplifies the “well” part of each veteran. Veterans are encouraged to identify and utilize inner strengths in their environment to rebound from difficulties and create the life that they want.

Family Group
Because the symptoms of PTSD and other trauma reactions change how a trauma survivor feels and acts, traumatic experiences that happen to one member of a family can affect everyone else in the family. This psycho-education, skills based support group, helps family members learn about trauma, its effects on the veteran, their  family, development of coping strategies  and emphasizes the need for self care.

Women’s Retreat
Consistent with a holistic approach to treatment and the rural locality of the BHHCS, the PCT program offers a Semi-Annual Women's Retreat for Women Veterans (all Eras)  and female family members of veterans that have been diagnosed with Post Traumatic Stress Disorder (PTSD).  Participants are educated about the frequently debilitating symptoms of PTSD and the disorder’s possible effect on the family.  Retreat participants are encouraged to examine problem areas in their lives. Significant emphasis is placed on development of healthier coping skills/strategies and exploring various techniques that might  increase self -management of symptoms. Seating is limited. Pre-registrations are required. Because of recent funding and logistical challenges, we will not be able to offer a retreat in Spring 2014. We hope to announce the dates for the Fall 2014 retreat in July 2014. If you have additional questions please contact the PCT program at 720-7449.

Residential PTSD Program

Coming Soon...

Contact us:

If you or someone you know would benefit from one of our programs, please contact us: 

Fort Meade 1- or
Hot Springs 1- or

PCT Outpatient Treatment Program contact information

113 Comanche Road
Fort Meade, SD 57741


Outpatient Locations and Schedules

Fort Meade Campus
Building 148 B Ward

Rapid City VA Outpatient Clinic
3625 S. Fifth Street
Monday, Tuesday and Thursday

Since many veterans live in the Rapid City area, additional PCT staff travel to the Rapid City VA Clinic on Tuesdays for outreach services.


Telehealth is available to the Northern Cheyenne, Standing Rock and Pine Ridge reservation. Telehealth helps bring PTSD services to Veterans who may otherwise go without service, given their rural setting.