News | June 29, 2018

A peek behind the curtain: The first step of PTSD care

By Shireen Bedi Air Force Surgeon General Public Affairs

Perhaps the most difficult part of seeking help for post-traumatic stress disorder is making that first appointment, since Airmen are often unsure of what to expect.

Not knowing what to expect from mental health providers can get in the way of effective PTSD treatment. Lt. Col. Joel Foster, the Air Force Mental Health Policy chief, stresses the importance of Airmen knowing the process of an initial meeting, which can help dispel myths surrounding PTSD treatment and alleviate concerns.

“The first thing patients should understand is that mental health providers strive to meet the patient where they are,” said Foster. “This all starts by creating a good relationship with the patient.”

In the initial meeting, the provider aims to establish a genuine connection with the patient. With the goal of building a trusting relationship, providers seek transparency about what they are doing and what they want to accomplish.

“I talk about everything from what I am writing down, what I don’t write down, where that record goes, and who has access to it,” said Foster. “I want to be open with what I am doing so the patient is aware and is also able to trust me.”

Informed consent is a central part of this process.

With informed consent, patients make their own decision on what approach will work best.  According to Foster, this allows patients to go into therapy with eyes wide open, knowing how a particular approach will affect their lives.

Therapy effectiveness also hinges on the quality of the relationship between patient and provider through genuine and authentic interaction. This type of relationship also supports a trusting alliance.

“If you see your mental health provider as someone you can trust and see him or her as someone who is emotionally engaging, then you are more likely to listen and understand his or her recommendations,” said Foster.

These efforts contribute to a collaborative relationship designed to provide the help patients need.

 “I will talk with patients about their goals and what they want to accomplish,” said Foster. “In turn, I discuss various psychotherapy techniques or approaches that may be effective and talk about the pros, cons and potential risks associated with each approach.”

The first visit will often give patients a more objective understanding of their situation.

“As a mental health provider, I want to get to know what they are struggling with so I can give them objective feedback that is genuine and legitimate,” said Foster. “Hearing objective feedback can be powerful, enabling patients to believe things about themselves they may not have believed before.”

 Providers understand therapy can be challenging, especially when disclosing personal and traumatic topics. As Foster explains, any long-term goal, such as getting treatment for PTSD, will have steps along the way that may not be enjoyable at the time.

“Taking that first step to seek help can be the toughest step, but Airmen should know that it is not nearly as difficult as they think it is going to be,” said Foster. “I have had patients tell me they have been putting off seeking treatment for years because they initially thought it would be a difficult process. Almost every patient, after we have done two or three sessions, says that it was easier than they had originally thought.”

The Air Force is always working to make access to PTSD treatment easier for Airmen. Not only does every base have a mental health clinic, but Airmen also have access to the Behavioral Health Optimization Program, or BHOP, through their primary care clinic.

As Capt. Jordan Fields, an Air Force clinical psychologist at Joint Base San Antonio, Texas, explains, having behavioral health specialists embedded into the primary care clinic makes it easier for patients to get the appropriate care they need.

“If symptoms are not easily managed within BHOP, patients are referred to a mental health clinic where they can receive effective PTSD treatment,” said Fields. “Whether a patient is referred to a mental health clinic or not, providers are focused on getting all Airmen healthy and fit to fight.”