Post-Traumatic Stress Disorder (PTSD)
Many veterans find themselves continuing to struggle with the aftereffects of severely stressful events (like combat, IED explosions, seeing comrades injured, or military sexual trauma). Some veterans may develop Post-Traumatic Stress Disorder as a result of such traumatic events.
Our team understands the special issues of veterans who are dealing with the effects of trauma. The PTSD Clinical Team (PCT) was created to help you feel more in control and increase satisfaction with your life by working with you to effectively address these issues.
Specific treatment recommendations are tailored to the needs of individual veterans. Treatment may consist of a mix of educational group meetings, therapy groups, and individual therapy for handling the symptoms of stress disorders such as PTSD. Utilization of local resources (e.g., Vet Centers, Community Based Outpatient Clinics, or private psychotherapists) is a vital element in serving the veterans in areas geographically distant from VA Medical Centers.
Eligibility and getting connected
Any veteran living in VISN 12 (Wisconsin, the Upper Peninsula of Michigan, or the upper portion of Illinois) who meets VA eligibility criteria is eligible for an initial consultative assessment interview.
The goal of this interview is to help the veteran gain a better understanding of his or her trauma-related difficulties. After the interview the team will develop recommendations, which may include participation in services offered by the PTSD Clinical Team (PCT) or services in other VA or community agencies.
Applying for Care through the VA
Learn how you can apply for care through the VA.
The steps required to receive service in the PTSD Clinical Treatment Program
The first step is to establish eligibility for VA Care. (For questions call 1-800-827-1000).
Next, the veteran needs to complete a consultative interview with the intake team (a clinician and a prescriber) in the Outpatient Mental Health Clinic. Veterans new to the clinic who arrive between the hours of 8:00 am and 12:00 pm, Monday through Friday (excluding federal holidays) will be seen the same day. These interviews generally will take about 2 hours. If you want to avoid waiting, the best time to come is 8:00 am since these interviews are conducted on a first come, first served basis.
Appointments are encouraged but are not required. If you call a day or two in advance, we can arrange parking for you for this visit.
Our clinic is located on the second floor of the hospital, in the Outpatient Mental Health Clinic. Please use the elevators or stairs located in the D wing. Inform the receptionist that you are here as a new patient and they will help you begin the process for seeing the intake team.
After the interview is completed, if the intake team believes the veteran has PTSD, they will then refer the veteran to the PTSD Clinic and help the veteran obtain an appointment. The intake staff may discuss other treatments that are deemed appropriate in addressing problems the veteran may be having. Once accepted into the PTSD Clinic, the veteran will meet with a clinician from the PTSD Clinic. For more info, please see Specialty Treatments Offered at the Madison VA PTSD Clinic below.
Specialty Treatments Offered at the Madison VA PTSD Clinic
Cognitive Processing Therapy (CPT). The way you think about things influences how you feel and what you do. Traumatic experiences can influence how you think about things, and this can keep you stuck feeling anxious or angry, even though the experience is over. The focus of CPT is to help you overcome the impact of trauma on how you think about the world, yourself, and others. You will learn strategies through written assignments that help you realistically challenge and change unhelpful thoughts and reactions related to trauma memories and triggers that are maintaining PTSD. CPT requires weekly 50-60 minute appointments for 12 weeks.
Prolonged Exposure (PE). It’s natural to avoid things that make us uncomfortable. Unfortunately, avoidance maintains symptoms of PTSD (especially anxiety) because you don’t have an opportunity to disconfirm your fears or get used to them. The focus of PE is to help people slowly face uncomfortable trauma related memories, triggers, and situations until they feel in control again. Therapy involves approaching avoided memories and situations in a gradual and safe way with the support of a therapist and doing weekly homework assignments. You’ll meet with your therapist for 90min/week for 9-12 weeks.
Written Exposure Therapy (WET). This is a brief 5-7 session exposure-based therapy with emerging evidence that shows it is effective for reducing PTSD symptoms. Veterans engage in therapist-led writing exercises during their appointments. This therapy differs from standard PTSD treatment as it is a shorter course and has fewer structured between session assignments.
Cognitive Behavioral Conjoint Therapy for PTSD (CBCT). CBCT is a PTSD intervention delivered in a conjoint format (i.e. patient with spouse, family member, etc.). This treatment is 15 sessions in length and also focuses on changing unhelpful thoughts, beliefs, and behaviors that prevent recovery. Emphasis is placed on addressing PTSD symptoms within a relationship context. This treatment is meant to be a front-line intervention for PTSD (i.e., not an adjunct to PE or CPT, above) for patients that opt for a conjoint approach, and there is a growing research literature behind it.
Cognitive Processing Therapy (CPT) Group. This group follows the same protocol described for the individual modality listed above. Again, the emphasis is on identifying unhelpful thoughts and beliefs related to self, world, and others; and challenging those thoughts in way that increases coping with PTSD and related triggers. The group does not include writing about your most traumatic experience, which is sometimes done in individual therapy. The group meets for 90 minutes per week for 12 weeks. Runs Tuesdays 9- 10:30am.
Post 9-11 Veterans’ Essentials Group. This is an information/topic-based group with open enrollment. This group is designed for OEF/OIF veterans who are struggling with trauma-related or transition concerns and may be helpful for those considering treatment, are engaged in treatment and want to start connecting with others, or have completed EBP and want to gain continued support. Topics are veteran-centered and revolve around the main areas of getting grounded in times of stress, finding meaning and motivation, and overcoming obstacles for change. This is a drop in group, although we encourage regular attendance. This groups meets Tuesdays 3-4:30pm.
STAIR (Skills Training in Affective and Interpersonal Regulation). This is a 12 week, 90 minute, closed group. This group is designed for individuals with a history of trauma, problems with emotion regulation and/or relationship problems. This group can be useful for veterans who may benefit from increasing emotion regulation skills before or while engaging in other trauma-focused treatments. Veterans who participate in the group can expect to learn about emotional awareness, emotional regulation/living an emotionally engaged life, and understanding/changing relationship patterns. The target population for this group are veterans with a primary diagnosis of PTSD or those with significant sub-threshold PTSD symptoms that are the intended focus of treatment. This group is intended as an adjunct skills-focused treatment that can be completed concurrently or prior to trauma-focused therapy.