How We Go About Choosing Treatment Paths for Veterans - a Q&A with Doctor Claire Price

What’s your name and role at Combat Stress?

“My name is Doctor Claire Price and I’m a Principal Clinical Psychologist at our England South Hub.”

Which trauma-focused therapies do we offer at Combat Stress?

“We offer Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), Narrative Exposure Therapy (NET) and Eye Movement Desensitisation and Reprocessing (EMDR).”

When deciding which trauma-focused therapy is best for a veteran, what do we consider? Can veterans voice their preference?

“When deciding on which trauma-focused therapy will be best for a veteran, we’ll think about veteran preference – this may include what kind of therapy they’ve had in the past and what has or hasn’t been helpful for them previously. We’ll also take into account the symptoms a veteran is presenting with and what we know works based on research and clinical evidence. There are many elements in a veteran’s presentation that might indicate certain therapies could be helpful. For example, NET might be suitable for a veteran who’s experienced multiple traumas throughout childhood and then during military and other periods of adult life. For a veteran who’s experiencing physical pain or other physical symptoms, EMDR might be the best course of treatment.”

How do we make sure veterans understand what their treatment is and the clinical rationale behind it before starting?

“We always want veterans to feel empowered and in control of their treatment, so we take a collaborative approach to treatment plans. Before starting any treatment, we’ll provide options to the veteran, and explain what their therapy will look like and what it will entail so they can make an informed decision. Ultimately, we want veterans to feel like they have ownership of their treatment plan, and that they have been able to make choices as part of that. We really like to work on things together – we believe that bringing veterans’ expertise in their own lives and  and our clinical expertise in treating PTSD together is the most powerful way of working towards recovery.”

How do we measure their wellbeing/progress throughout the treatment?

“We ask veterans to fill in questionnaires to record their wellbeing and measure if things are improving. If a veteran needs support to complete the questionnaires, one of our peer-support workers can help fill these in over the phone instead. These measures are incredibly important as they help us know whether someone is recovering or not, as well as if there are any remaining needs we need to address. Our therapists will also regularly ask for feedback throughout a veteran’s treatment journey to assess the effectiveness of the therapy sessions.”

What support is available for veterans after they complete therapy?

“It’s important to know that every veteran’s treatment journey is unique and tailored to their needs. Every veteran’s needs are different, and so we’ll always review at the end of each part of treatment to think about their goals and any unmet needs that we can help with at Combat Stress. Sometimes, veterans will find it helpful to have a community of veterans around them and will go on to meet with our peer support workers after treatment. At other times, we might refer veterans to other organisations that might be better placed to address remaining needs. We’ll always think about what a veteran might need next, whether that’s within Combat Stress or elsewhere. It can often be important for veterans to take a break from therapy after completing a course of treatment; it’s crucial they have time and space to consolidate learning from therapy and implement it into their everyday lives. We know this improves the effectiveness of treatments.”

How do we ensure the quality of our care? Can veterans leave feedback about their treatment?

“Firstly, we ask all veterans for feedback, both while they’re having treatment and after they’ve completed it. All of our psychologists and psychotherapists are trained in at least two trauma-focused therapy models and undergo regular specialist supervision and training. Decisions around treatment and care are always made as a team, so that we can ensure the veteran is getting the right support. We also always make sure we’re up to date with the new knowledge and information that’s coming through from research so that we can ensure we are providing the most effective treatments. We have an internationally recognised research department at Combat Stress also working to establish the best treatment for veterans with mental health difficulties. We have developed a sophisticated platform to make it easy for veterans to complete questionnaires, provide feedback and see over time how their symptoms are changing. Called the Clinical Quality and Effectiveness Data (QED) platform, as a clinical service we can now analyse the outcomes of our treatments. It’s about making sure we’re always monitoring our recovery rates, which we are very proud of, and continually striving towards excellence.”