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Troubleshooting Lack of Improvement in PTSD Treatment
Abigail Angkaw, PhD and Cynthia Yamokoski, PhD
Wednesday, July 20 at 2:00pm ET
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Photo by Vanessa Garcia via Pexels
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About the Presenters
ABIGAIL ANGKAW, PhD is a clinical psychologist, Deputy Associate Chief of Staff for Outpatient Mental Health Clinical Operations at the VA San Diego, an Associate Clinical Professor at the University of California, San Diego, and a consultant for the PTSD Consultation Program. Dr. Angkaw specializes in questions related to treatment, assessment, and clinic administration, including Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Clinician Administered PTSD Scale (CAPS-5), measurement-based care, motivation and engagement, and program improvement. Dr. Angkaw was previously a national PE consultant and a regional mentor in the VA PTSD Mentoring Program. Her primary research interests include PTSD and co-occurring conditions as well as improving the delivery of mental health treatment. As a VA provider and coming from a military family, Dr. Angkaw is personally invested in helping providers through complex clinical and administrative challenges to provide high quality care for Veterans with PTSD. Dr. Angkaw received her PhD from the University of Cincinnati. She completed her predoctoral internship in PTSD and comorbid substance use disorders and her postdoctoral fellowship in combat PTSD research at the University of California, San Diego/VA San Diego.
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About the Topic
Trauma-focused psychotherapy is strongly supported for the treatment of posttraumatic stress disorder (PTSD) within multiple clinical practice guidelines. Even though many patients in evidence-based therapy for PTSD see significant improvement in their symptoms in a few weeks, some patients do not seem to improve during treatment and clinicians are sometimes unsure how to address this. This lecture will provide a framework for examining progress in treatment, potential indicators for lack of improvement, and recommendations for how to proceed in these cases. Research and literature associated with PTSD treatment planning and progress will be reviewed to help clinicians with decision-making.
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CINDY YAMOKOSKI, PhD is a clinical psychologist, the Associate Director of the PTSD Mentoring Program, and Senior Clinical Instructor at the Case Western Reserve University. Her research and clinical interests include clinic flow/design, treatment of co-occurring PTSD and substance use disorders, combat-guilt, implementation of clinical innovations, and strategies to increase the delivery of EBPs with complex populations. Dr. Yamokoski and her colleagues in Cleveland, where she formerly served as Section Chief for Specialty Mental Health at VA Northeast Ohio Healthcare System, have developed and implemented an intensive two- and four-week PTSD program utilizing massed delivery of evidenced-based psychotherapy for PTSD, and she is facilitating the implementation of this model in additional PTSD programs within the VA system. Dr. Yamokoski earned her doctorate from the University of Akron.
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Providing Mental Health Care for Those Who Experienced Military Sexual Trauma
Military sexual trauma (MST) refers to sexual harassment or sexual assault that occurs during an individual's military service. Not everyone who experiences MST will face long-term health consequences but experiencing MST does increase the likelihood of mental and physical health problems and readjustment challenges. Risk and protective factors specific to the individual and that individual's environment influence the intensity, duration and trajectory of health consequences.
Read the full article to learn about psychological assessment, treatment and clinical resources
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Resources for Veterans Who are MST Survivors
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Military Sexual Trauma Our shareable webpage written for Veterans.
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AboutFace Stories from Veterans who experienced MST talking about how treatment can help.
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Military Sexual Trauma Fact Sheet
Background information about MST, including what it is, how it can affect survivors, and help available through VA.
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Brochure for MST Survivors (English / Spanish)
An overview of issues related to MST and how to access VA services.
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Men and MST — Educational Brochure (English / Spanish) and Infographic (English / Spanish)
Information on men’s recovery from MST.
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Women and MST — Infographic (English | Spanish)
Information on women’s recovery from MST.
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VA’s Health Care Services for MST
Summary of eligibility requirements and types of MST-related health care services available through VA.
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VA Disability Compensation for Conditions Related to MST— Fact Sheet and General Information —
Details on VA’s disability compensation for conditions related to MST. (Veterans do not need to have a VA disability rating to receive free MST-related treatment through VA.)
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Beyond MST Mobile App
The Beyond MST app was created for survivors of military sexual trauma (MST). Veterans of all genders and backgrounds have experienced MST. The app offers information and resources to help survivors cope with challenges related to MST and improve their health, relationships and quality of life.
The app is free and available for both iOS and Android devices.
With Beyond MST survivors can:
- Learn about common challenges related to MST and skills and resources that can help
- Use over 30 tools to help them cope with problems, reduce distress and improve their quality of life
- Take brief assessments to understand symptoms and beliefs
- Track progress toward recovery goals
- Find new sources of support and read inspiring messages from other sexual trauma survivors
Learn more and download the free app
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To review the resources shared in previous newsletters please visit our archive.
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Our team of expert clinicians is available to consult with any healthcare provider treating U.S. veterans in any setting.
We can discuss assessment, diagnosis, psychotherapy, medications, collaborating with VA care, patient and family education, continuing education, and just about anything else related to veterans and PTSD.
No question is too big or too small.
Contact us at PTSDconsult@va.gov or 866-948-7880.
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www.ptsd.va.gov/consult |
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