Therapy for Veterans
Veterans may face any number of challenges throughout their military involvement. And, all too often, they do not get the resources they need to help address those many challenges. Veterans returning to civilian life may not know where to get the support they need.
As many as 13.5% of veterans who served during the Iraq and Afghanistan crises had PTSD 1. An estimated 41% of veterans suffer from some type of mental health challenge2.
Successful veteran mental health services can go a long way toward ensuring that veterans can overcome mental health issues. In many cases, veterans are able to go on to live happy and productive lives. The VA identifies several types of evidence-based treatment that work well for veterans suffering from severe mental health conditions.
Acceptance & Commitment Therapy (ACT) for Depression
Depression is a common issue among many veterans. They may struggle with feeling like things are outside their control, and they have little that they can do about their challenges. Elevated levels of depression generally occur in around 9.9% to 11% of veterans 3.
Acceptance and commitment therapy, also known as ACT-D therapy, helps veterans learn how to manage negative thoughts and feelings. This type of therapy can ultimately help them lead lives better aligned with their values and filled with more joy. ACT-D therapy can help many veterans learn how to focus on the things that are important to them.
ACT-D therapy generally requires around 10-16 sessions. However, some veterans will need additional time to go through those sessions, while others may see results sooner. It requires a commitment to attending regular therapy sessions and speaking openly about their symptoms.
Behavioral Activation Therapy
Behavioral activation therapy focuses on changing how people suffering from depression interact with their environments 4. Behavioral activation therapy is an affordable, effective method for dealing with depression in veterans. This type of therapy may be more accessible than other types of treatment for depression.
Through behavioral activation therapy, veterans will learn to identify rewarding activities, including hobbies and interests. In many cases, veterans may lose track of those regular hobbies due to frequent deployments or a lack of free time.
Behavioral activation therapy can help many veterans identify the areas of life that bring them joy or peace. Then they find ways to include these specific elements in their daily lives. It may also include the chance to engage in more social activities, which can help positively impact depressive symptoms.
Behavioral activation therapy encourages veterans to participate in those activities even though they may feel uncomfortable. The mental health professional and the veteran will work together to identify healthy behaviors. Therapists will encourage the patient to integrate them as part of regular routines.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy helps address the behaviors that may cause a veteran to engage in substance use. Through cognitive behavioral therapy, veterans will work to identify the specific triggers that cause them to want to use substances. Then come up with alternate behaviors that can help address those concerns. Cognitive behavioral therapy can also treat anxiety, depression, or panic attacks often associated with PTSD.
Cognitive behavioral therapy often starts with identifying the negative thought cycles that lead to a specific reaction. For example, the therapist might identify thoughts that commonly cause depression or anger.
These emotional reactions may, in turn, lead to stimulant use to escape those feelings. Then, the therapist might challenge those thoughts and replace them with more realistic ones. A veteran might, for instance, have the negative impression that he no longer fits into his family. A therapist will help replace that thought pattern by assisting the veteran in reframing the negative thoughts.
The therapist might identify the specific triggers that make the veteran think they need to use certain substances. Then the therapist will teach the veteran to reframe triggers when they occur. The process of reframing triggers can help veterans learn how to manage their thoughts and feelings healthily.
Cognitive behavioral therapy requires a strong commitment on the part of the veteran. The veteran will need to use the skills learned during those sessions in the real world.
Contingency management is designed to help provide some type of incentive to help the patient avoid substance use. Over the course of a lifetime, more than half of veterans already have a tobacco use disorder. And more than a third of veterans will suffer from some type of substance use disorder 5.
Substance use disorders can lead to many other problems in the veteran’s life. Such issues include difficulty with anger management, social interaction, or financial management. Those intrinsic benefits of staying away from those substances may not be enough to keep veterans struggling with substance abuse clean.
Through contingency management, many veterans can receive the external incentive they need to avoid substance use. Contingency management therapy relies on urine tests to identify substance use or abuse. This therapy provides incentives that encourage the patient to continue to meet those goals.
Cognitive Processing Therapy
Many veterans go through significant trauma, which can prove challenging to deal with. Many veterans may struggle with trauma during their service and when they attempt to reintegrate back into society. In many cases, cognitive processing therapy can help veterans address the challenges they may face because of their service.
During cognitive processing therapy, veterans will be encouraged to speak frankly about the trauma they have experienced. For many, simply talking about those past events can give them closure.
By talking through distressing situations, veterans are able to open up and process certain events and triggers. As part of cognitive processing therapy, veterans are encouraged to identify and discuss the negative thoughts and associations from those events. They will learn how to address them and replace them with more positive associations. Through CPT, many veterans can identify more healthy coping mechanisms for their mental health challenges.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioral Therapy, or DBT, is a form of therapy that helps identify and correct self-harming behaviors in veterans. Self-harming behaviors do not have to include self-injury alone. In many cases, self-harm takes the form of inadequate nutrition, exercise, or sleep or may consist of drug or alcohol abuse.
DBT has several vital elements. Most notably, it starts with acceptance: identifying the problem and its challenges, including the stimulus for those problems. Then, the veteran will identify skills that can help shift those negative behaviors and lead to more positive overall outcomes.
DBT may mean taking several steps to create change in a person’s mental health. This therapeutic approach encourages the veteran to identify negative emotions and ask for help when needed. Or therapists may work with the veteran to identify more positive behaviors and how to engage in them regularly.
In addition, DBT helps patients build overall mindfulness. Which can help keep them in the present and help them build more positive relationships. The patient may be better positioned to maintain overall mental health by learning these coping skills. DBT can prove particularly helpful for patients who struggle with emotional or relational highs and lows.
DBT is a long-term commitment. It can take as many as six months for veterans to start to see results through dialectical behavioral therapy. As therapy continues, many veterans will begin to develop stronger coping mechanisms that can help carry them in the future.
EMDR Therapy for PTSD
Eye Movement Desensitization Reprocessing therapy, also known as EMDR, is used to help with PTSD symptoms in veterans and non-veterans. Through EMDR therapy, patients will process traumatic memories and change the associations they may have with those memories.
They start by recalling a traumatic memory while looking at a rapidly moving picture or listening to a series of sounds. The negative emotions associated with that memory will generally decrease throughout the session. However, it can take time for veterans to fully adapt to those changing responses. With consistency and therapy, people can reframe their responses and work through painful emotional triggers.
During EMDR, the therapist will work to help the veteran replace the negative associations of an event with positive thoughts. Eventually, the patient will learn to incorporate relaxation techniques and other strategies. Patients will learn healthy coping skills that can help alleviate feelings of trauma or symptoms of PTSD.
Motivational therapy explores the motivation behind changing dangerous behaviors, including drug or alcohol addictions. Through motivational treatment, patients will explore the reasons why they might want to change specific behaviors. They will learn the steps they may need to take to improve their well-being.
For example, the veteran might identify the negative impact of a specific type of behavior, including negative work or relational challenges. Then, the veteran can help identify future treatment strategies that may offer additional help.
Motivational therapy focuses on the veteran’s right to choice in various scenarios. The right to choice is available even when others might not necessarily agree with those determinations.
Prolonged Exposure Therapy (PE)
Prolonged exposure therapy helps address symptoms of PTSD. This therapy includes discussing triggers, challenges, or negative associations that may negatively impact the veteran’s life. Veterans with PTSD may struggle with specific stimuli that make it more challenging to go out in public.
They may have trouble with loud noises, crowded areas, or specific types of behavior from other individuals. As a result, they may start avoiding everyday interactions with others. They may do this to the detriment of their overall mental health and comfort.
Prolonged exposure therapy helps address those concerns and provides veterans with more healthy coping mechanisms. It may involve strategies like relaxation or breathing exercises that can help temporarily alleviate those symptoms. Or the therapy might help patients process those traumas, ultimately allowing for more freedom in everyday life.
Social Skills Training
Many veterans, especially those with significant mental health disorders, may have problems in various social settings. Some veterans struggle with military interactions being very different from civilian ones. Others may not have had the chance to develop healthy social skills that allow them to function well in specific settings.
Through social skills training, on the other hand, veterans will have the ability to develop those vital skills6. Social skills training, such as support groups, often occurs in a group setting. This way, multiple people can work together to identify their potential weaknesses and build them back up. In addition, veterans can receive peer support by practicing social skills with fellow veterans.
Family and Relational Therapy
Many veterans struggle with their mental health disorders in silence. However, those disorders can impact every aspect of their lives, including their relationships and families. In many cases, going through family and relational therapy together can offer several benefits.
Repair Broken Relationships
Sometimes, addressing some of the mental health symptoms the veteran has to face starts with repairing broken relationships. Relationships often stretch thin throughout long deployments or strain under the impact of mental health issues. Repairing those relationships for the veteran can be crucial to recovery.
Stable relationships are essential for mental health and offer additional veteran support. In addition, working with a therapist can help provide a different perspective, which may help improve those relationships.
Provide Family Members with Coping Mechanisms
Conditions like PTSD, anxiety, depression, and substance abuse can be challenging for the struggling person. However, it can also be challenging for loved ones to see a veteran struggling with their mental health.
Those family members can develop more effective coping mechanisms through family and relational therapy, which may, in turn, help them address the challenges that they face. This ultimately puts loved ones in a better position to support their veteran family member.
Gain Better Insights
Often, it is difficult for veterans to clearly express their feelings and what they’re dealing with. They may struggle to clearly define those issues for their family members and friends. Through family therapy, those loved ones can develop a better understanding of the veteran’s experience. This can help them be more sympathetic when mental health issues cause problems.
Learn How to Help
Sometimes, veterans struggle to clearly identify what help and support they may need on their own. They may be embarrassed or struggle to understand exactly what might help.
Loved ones want to support the veterans in their life in the best way possible. However, they might be unsure how to help the veteran in challenging moments. Family therapy can help loved ones understand what the veteran needs and how they can best support them. Many service members struggle in silence without receiving mental health care. Loved ones can help by finding mental health resources that are explicitly aimed at treating veterans.
Therapeutic Treatment for Veteran Mental Health
Therapy for veterans can help address many underlying mental health concerns and help vets go on to live more fulfilling lives. At Solara Mental Health, we provide various treatment options for veteran mental health. Mental health treatment can help veterans learn how to manage their mental health symptoms and live healthy lives.
Contact us today to learn more about the support and resources we may have available.
- Reisman M. (2016). PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next. P & T : a peer-reviewed journal for formulary management, 41(10), 623–634.
- National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee to Evaluate the Department of Veterans Affairs Mental Health Services. Evaluation of the Department of Veterans Affairs Mental Health Services. Washington (DC): National Academies Press (US); 2018 Jan 31. 6, Department of Veterans Affairs Mental Health Services: Need, Usage, and Access and Barriers to Care. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499497/
- Gould, C. E., Rideaux, T., Spira, A. P., & Beaudreau, S. A. (2015). Depression and anxiety symptoms in male veterans and non-veterans: the Health and Retirement Study. International journal of geriatric psychiatry, 30(6), 623–630. https://doi.org/10.1002/gps.4193
- Uphoff, E., Ekers, D., Robertson, L., Dawson, S., Sanger, E., South, E., Samaan, Z., Richards, D., Meader, N., & Churchill, R. (2020). Behavioural activation therapy for depression in adults. The Cochrane database of systematic reviews, 7(7), CD013305. https://doi.org/10.1002/14651858.CD013305.pub2
- Boden, M. T., & Hoggatt, K. J. (2018). Substance Use Disorders Among Veterans in a Nationally Representative Sample: Prevalence and Associated Functioning and Treatment Utilization. Journal of studies on alcohol and drugs, 79(6), 853–861. https://doi.org/10.15288/jsad.2018.79.853
- US Department of Veteran Affairs. (2022, April 25). VISN 5 MIRECC – VA Social Skills Training for Serious Mental Illness (SST) Training Program. Va.gov: Veterans Affairs . Retrieved September 20, 2022, from https://www.mirecc.va.gov/visn5/training/social_skills.asp