Find a CBT Therapist
Search through our directory of local clinicians.
Military Veterans Mental Health
Though military personnel and veterans can experience the full range of mental health conditions, research suggests they are more likely to be diagnosed with mood and anxiety disorders, including depression, panic, and posttraumatic stress disorder (PTSD), as well as anger-related disorders. Approximately 25% to 50% of military personnel with these mental health conditions first experienced the onset of the condition prior to joining the military. Though mental health conditions, in general, are associated with increased risk for suicidal thoughts and behaviors, among military personnel, depression, PTSD, and alcohol use problems seem to have the strongest relationship with suicide risk. Research also suggests that mental health conditions that are first experienced after joining the military (as compared to conditions first experienced before joining the military) may have a relatively stronger association with suicidal behavior.
The past decade has seen a rapid expansion of efforts aimed at developing and testing treatments for military personnel and veterans struggling with these conditions.
Posttraumatic Stress Disorder
Two types of trauma-focused treatments have been found to be especially beneficial for individuals with PTSD: prolonged exposure (PE) and cognitive processing therapy (CPT). These treatments were initially developed outside the military to help individuals with PTSD, and have subsequently been adapted for use with military personnel and veterans as well. In PE, individuals tell the story of their traumatic event and confront reminders of that event, which enables them to tolerate the associated uncomfortable thoughts and feelings. In CPT, individuals focus on changing how they think about the stressful event so they view themselves and the world in a more balanced way.
More than two-thirds of individuals with PTSD who begin PE and CPT no longer have PTSD afterward. The likelihood of recovery increases among those who complete the entire treatment: approximately 90% of individuals completing the treatments no longer have PTSD afterwards. Recovery often occurs in fewer than 12 outpatient appointments. The benefits of PE and CPT last for many years after treatment. Although recent research suggests that recovery rates from PTSD are somewhat lower for military veterans than for civilians, more than half of veterans who receive these treatments recover from PTSD.
Two types of psychological treatments that are effective for reducing depression include cognitive behavioral therapy for depression (CBT-D) and interpersonal psychotherapy (IPT). Both treatments involve participating in up to 20 individual therapy sessions. In CBT-D, the focus of treatment is on changing thoughts and assumptions that may contribute to depression (e.g., pessimism, self-criticism) and increasing one’s engagement in enjoyable and meaningful activities (e.g., resuming hobbies, increasing exercise, spending time with others). In IPT, the focus of treatment is on changing relationship issues that may contribute to depression (e.g., conflict with romantic partners and others).
Over 75% of individuals, including military veterans, treated for depression report significant improvements after CBT-D and IPT. Both CBT-D and IPT have also been found to reduce the risk of experiencing another depressive episode. Among those who receive these therapies and experience another depressive episode, the severity of the subsequent episode is usually reduced.
Two treatment approaches are considered to be effective for preventing suicidal behavior among high-risk individuals: dialectical behavior therapy (DBT) and cognitive therapy for suicide prevention (CT-SP). DBT is a 12-month treatment that includes weekly individual therapy sessions, weekly group skills training sessions, and regular phone contact with a clinician. CT-SP is a 10-session treatment that includes individual therapy sessions that teach skills to manage emotional distress and to change how one thinks about oneself. Both treatments have been found to reduce suicidal behaviors by 50% in nonmilitary samples.
A 12-session adaptation of CT-SP, referred to as brief cognitive behavioral therapy (BCBT), has been tested among military personnel and found to reduce suicide attempts by 60%. In addition to reducing suicidal behavior, BCBT is associated with decreased depression, hopelessness, anxiety, and PTSD symptoms. Suicidal military personnel treated with BCBT may also be less likely to be medically discharged from the military.
More information about military veteran mental health:
National Center for PTSD: www.ptsd.va.gov
National Center for Veterans Studies: www.veterans.utah.edu
Center for Deployment Psychology: www.deploymentpsych.org
More information about treatments that work:
Interpersonal Psychotherapy for Depression: www.mentalhealth.va.gov/depression/ipt.asp
Cognitive Behavioral Therapy for Depression: www.mentalhealth.va.gov/depression/cbt-d.asp
Prolonged Exposure for PTSD: www.mentalhealth.va.gov/ptsd/pe-ptsd.asp
Cognitive Processing Therapy for PTSD: www.mentalhealth.va.gov/ptsd/cbt-ptsd.asp
Brief Cognitive Behavioral Therapy for Suicide Prevention: http://deploymentpsych.org/blog/guest-perspective-targeting-suicide-risk-itself-notpsychological-disorders-reduces-suicidal-behavior