Managing the Approach-Avoidance Dialectic in Treating a Complex Veteran With Panic and Posttraumatic Stress Disorder

Beason-Smith, Melissa; Hiatt, Emily L.; Grubbs, Kathleen M.; Teng, Ellen J.

doi:10.1177/1534650112442109

Cited by 2 publications

(2 citation statements)

References 40 publications

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“…Despite the many advantages inherent in treatments such as IPCT, intensive exposurebased treatment may not be appropriate for all persons. Careful assessment and screening of clinical severity (e.g., severe depression or psychotic features) and consideration of treatment interfering behavior resulting from severe Axis II pathology are critical to the success of intensive group treatments (Beason-Smith, Hiatt, Grubbs, & Teng, 2012). The faster pace and volume of information in intensive treatment formats may not be suitable for individuals with cognitive difficulties.…”

Section: Discussionmentioning

confidence: 99%

Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study

Teng

Barrera

Hiatt

et al. 2015

Journal of Anxiety Disorders

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This pilot study examines the feasibility, acceptability, and potential effectiveness of delivering an intensive weekend group treatment for panic disorder (PD) to Veterans returning from deployments to Iraq and Afghanistan with co-occurring posttraumatic stress disorder (PTSD). The treatment program lasted 6h each day and was delivered by two experienced therapists. Patients received core components of panic treatment, including psychoeducation, cognitive restructuring, and interoceptive exposure. The interoceptive exposure exercises directly targeted anxiety sensitivity, a psychological construct also implicated in the maintenance of PTSD. Eighty-nine percent of patients who expressed interest in the treatment attended a baseline evaluation, and 63% of those who were study eligible initiated treatment. Treatment retention was high, with all 10 patients who initiated treatment completing the program. Veterans reported finding the treatment and delivery format highly acceptable and reported high levels of satisfaction. Panic symptoms improved significantly following the treatment and were maintained at a 7-month follow-up, with 71.4% of the sample reporting being panic free. Co-occurring PTSD symptoms also improved along with symptoms of anxiety and depression. Preliminary findings suggest that brief and intensive group treatments for PD/PTSD are a promising method of delivering cognitive behavioral therapy that may rapidly improve symptoms. This innovative treatment delivery format also may be a cost-effective way of increasing treatment engagement through increased access to quality care.

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Section: Discussionmentioning

confidence: 99%

Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study

Teng

Barrera

Hiatt

et al. 2015

Journal of Anxiety Disorders

Self Cite

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“…The VHA has identified CBT as an evidence-based treatment for PTSD, anxiety, depression, and obesity (Karlin et al, 2010). There is also support for its success in treating Veterans with multiple of these disorders concurrently (Beason-Smith, Hiatt, Grubbs, & Teng, 2012; Chaison, Dunn, & Teng, 2010). Given the high prevalence of obesity in Veterans with PTSD symptoms, poor weight-management outcomes among Veterans with symptoms of PTSD in MOVE!®, and desire to integrate PTSD symptom management into MOVE!®, we decided to evaluate the effectiveness of HELP among Veterans with PTSD.…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

Decreasing PTSD and Depression Symptom Barriers to Weight Loss Using an Integrated CBT Approach

Trahan

Carges

Stanley

et al. 2016

Clinical Case Studies

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This is a single-case study of an obese African American female Veteran who has posttraumatic stress disorder (PTSD) and depression. Her presenting psychological symptoms included clinically significant night terrors, insomnia, low self-worth, low motivation, and social isolation. Poor dietary and physical activity responses to her psychological symptoms contributed to her weight gain, as well as interfered with weight-loss efforts. A telephone-based cognitive behavioral treatment integrating mental and behavioral health principles was provided. Over the course of eight sessions, the Veteran learned psychological symptom and behavioral monitoring, thought stopping, cognitive restructuring, deep breathing, calming thoughts, social support, sleep hygiene, and problem-solving skills. Client-centered PTSD and weight-management treatment goals were integrated into each session. The client evidenced weight loss, improved dietary and physical activity habits, and experienced a reduction in PTSD and depression symptoms. This case study demonstrates that an integrated cognitive behavioral treatment approach can be beneficial for decreasing PTSD and depression barriers to weight loss.

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Managing the Approach-Avoidance Dialectic in Treating a Complex Veteran With Panic and Posttraumatic Stress Disorder

Cited by 2 publications

References 40 publications

Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study

Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study

Decreasing PTSD and Depression Symptom Barriers to Weight Loss Using an Integrated CBT Approach

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