PTSD Care

About the Program
There are five PTSD Clinical Teams (PCT) throughout the North Florida/South Georgia Veteran Health System (NF/SGVHS). PCTs are located in Gainesville, Jacksonville, Lake City, Tallahassee, and The Villages. Time spent in the PCT, whether for evaluation or treatment, is focused solely on recovery. PTSD specialty care is time-limited and focused specifically on reduction of PTSD symptoms. PTSD specialty care providers prioritize the offering of Evidenced-Based Therapies. The majority of clinical services are focused on delivery of VA/DoD Clinical Practice Guideline recommended care. Therapy will involve directly discussing the trauma. Engagement in the PCT requires attendance to  weekly appointments (in person or telehealth) and the completion of work outside of treatment session. Referral to the PCT can be made by your mental health or primary care behavioral health provider.

Evidence-Based Therapies
Trauma-focused Evidenced-Based Therapies (EBTs) are the most highly recommended treatment for PTSD. “Trauma-focused” means that the treatment focused on your memory of the event or its meaning. NF/SGVHS PCTs offer three of the most effective trauma-focused therapies. These therapies are considered the gold-standard for PTSD. These treatments use different techniques to help you process your traumatic experience. Some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions.

• Cognitive Processing Therapy for PTSD - PTSD: National Center for PTSD (va.gov): CPT teaches people to identify how traumatic experiences have affected their thinking. It also teaches them to evaluate and change their thoughts. CPT usually takes 12 sessions and can be delivered in an individual or group format. Individual sessions are 60 minutes long. Group sessions are usually 90-120 minutes in length. The goal is for patients to learn ways to have more healthy and balanced beliefs about themselves, others, and the world.

• Prolonged Exposure for PTSD - PTSD: National Center for PTSD (va.gov): PE works by teaching people to approach trauma-related memories, feelings, and situations that they have been avoiding since their trauma. By confronting these challenges in a gradual way with the help of a PTSD  therapist, PTSD symptoms can decrease. PE typically lasts for 8-15 90 minutes sessions.
• Eye Movement Desensitization and Reprocessing (EMDR) for PTSD - PTSD: National Center for PTSD (va.gov): In EMDR, patients pay attention to a back-and-forth movement while calling to mind the upsetting memory until shifts office in the way they experience that memory and more information from the past is processed. By processing these experiences, people can get relief from PTSD symptoms and change how they react to memories of their trauma. EMDR can take up to 12 sessions.

Other treatments  
Sometimes individuals need additional assistance to prepare for the intensity of trauma focused evidenced-based therapies. The PCT provides a variety of group therapies designed to gain a greater understanding of trauma, related symptoms, and the development of coping skills to improve the management of symptoms. Please note, some therapy groups may not be available at each location.

• Skills Group – Addresses topics such as education about PTSD symptoms and how to manage them more effectively. Topics include relaxation techniques, anger management, and cognitive reframing.  There is no discussion of specific traumatic events.  The group is open (patients can join at any time in the rotation) and held weekly for up to 12 weeks.  There are multiple different options for days and times. Education on EBTs is provided throughout the skills group rotation.
• Skills Training in Affective and Interpersonal Regulation (STAIR) Group – Addresses topics such as education about PTSD symptoms and how to manage them more effectively. Topics include coping skills to manage emotions and improve relationships.  There is no discussion of specific traumatic events. Discussion about the impact of trauma, rather than directly talking about traumatic experiences, will be encouraged. The group is open (patients can join at any time in the rotation) and held weekly for up to 12 weeks.  There are multiple different options for days and times.  
• Acceptance and Commitment Therapy (ACT) for PTSD Group – ACT for PTSD targets experiential avoidance, which is the avoidance of emotional states, thoughts, and physiological experiences that are considered negative or unwanted. Unlike cognitive behavioral therapies, the goal of ACT is not to reduce the presence of unwanted internal experiences. Instead, the goal is to help Veterans “make room” for their past traumas by increasing psychological flexibility. Core ACT skills are taught to help Veterans be able to acknowledge their negative internal experiences and pursue a meaningful life despite their presence. The group has been adapted to be an open group (patients can join at any time in the rotation) and held weekly for up to 10 weeks. 

Psychiatric Assessment and Medication Management 
Veterans enrolled in the PCT clinic can request assessment by a PCT prescribing provider to discuss the possibility of medications to help manage their symptoms.  Veterans who are currently working with a provider in the have the option of remaining with their current provider or transferring to the PCT provider.  Medication management is not a requirement of the clinic. Medication management is not provided in the absence of therapy.