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VICTOR Online Treatment

VICTOR Online Programme

Veterans’ Intensive Complex Trauma Organised Recovery

What is VICTOR

VICTOR (Veterans’ Intensive Complex Trauma Organised Recovery), our intensive treatment service for PTSD and Complex PTSD, is a highly specialised service and is at the forefront of clinical innovation.  

VICTOR is a three-phased treatment programme comprising two weeks of preparatory work, a two-week intensive treatment phase, and three months of follow-up support. All phases are delivered online. Veterans taking part in VICTOR progress through treatment as part of a cohort of up to eight veterans and attend a variety of groups in addition to their individual treatment sessions.    

The intensive treatment phase provides up to 24 hours of evidence-based trauma-focused psychological therapy, as well as a comprehensive range of wider multidisciplinary treatment, and peer and family support to ensure an individualised approach. 

The treatment is intensive by design (veterans will receive up to 24 hours of psychological therapy in two weeks). This is because intensive treatment typically results in much higher completion rates compared to weekly treatment and can accelerate recovery whilst minimising the impact of treatment on family life and work.  

The three months following the intensive treatment phase allow time for progress veterans made during intensive treatment to continue and enables us to support veterans further as they continue their journey to recovery. The follow-up phase concludes with a review appointment with their allocated psychological therapist to review progress, explore any outstanding needs and consider next steps.  

After this point, veterans might go on to access our peer support service (for up to a year); they may be discharged, or they may engage in further treatments to aid their ongoing recovery. 

Since the launch date of 1st October our recovery rates are as follows:

VICTOR Online: 75% PTSD recovery rate

Intensive 1:1 programme: 83% PTSD recovery rate

 

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This short film profiles a veteran’s experience of undertaking VICTOR, our intensive treatment service for PTSD and Complex PTSD. The film provides an insightful summary of the difficulties veteran Dave faced before treatment, his experience of treatment, and what life is like post treatment.


CLINICAL

  • Presenting with severe and/or chronic PTSD or C-PTSD with or without co-morbidities
  • Motivated to recover from the impact of traumatic experiences
  • Readiness for trauma-focused treatment as assessed by psychological therapist and agreed by MDT
  • Sufficiently stable across the dimensions of risk, substance/alcohol use, emotional dysregulation, dissociation (may be features of current presentation but not severe currently)
  • Veterans with C-PTSD should have received appropriate preparatory stabilisation in the areas of emotional regulation, intra or interpersonal, where it is likely to be vital to the successful completion of trauma-focused therapy subsequently
  • Veterans with PTSD should have received at least some basic psychoeducation and formulation in relation to their PTSD
  • May have previously accessed trauma-focused therapy which did not result in required therapeutic benefit or was interrupted by life events related or unrelated to mental health presentation
  • Able to take responsibility for commitment to treatment and own risk-management, and has well-developed risk management plan with protective factors
  • Would benefit from momentum of intensive treatment and/or veteran cohort and/or interdisciplinary treatment integration, particularly across dimensions of risk, substance/alcohol use, emotional dysregulation or dissociation to maximise treatment adherence, therapeutic effectiveness and care management
  • Op COURAGE assessment required

SERVICE ACCESS

  • Veteran unable to utilise online trauma-focused therapy with Combat Stress due to lack of quiet, confidential space in home environment (for residential intensive treatment)
  • Strong veteran preference for in-person treatment and is geographically distant from any clinical hub (for residential intensive treatment)
  • Physical health issues preclude regular travel to one of our hubs locally to receive treatment (e.g. chronic pain, disability, mobility issues) (for residential or online intensive treatment service)

OTHER

  • Where intensive treatment in a compressed format is much more feasible for veteran than weekly appointments either online or in-person at clinical hub, due to work, home or other commitments
  • Where rapid treatment might be warranted to mediate against the risk of job losses or relationship breakdown with partners, families or children are high due to PTSD or C-PTSD
  • Veteran has some positive social support (partner/ family/ friend/ carer) including a person who can act as the veteran’s supporter throughout their treatment, including before and after the intensive treatment phase


CLINICAL

  • Interpersonal functioning that would impede capacity to benefit from veteran cohort and/or potentially be disruptive to others’ treatment
  • Severe / active risk, emotional dysregulation or dissociation that requires further stabilisation
  • Current mental health, physical health, familial, social or other issues that will interfere with the veteran’s ability to fully engage in treatment

SERVICE ACCESS

  • Unable to access and/or attend all online appointments during the preparation and follow-up phases of the programme

SUBSTANCE USE

  • Unable to maintain abstinence from alcohol or substance use for duration of intensive treatment, and 2-weeks preceding intensive treatment
  • Veteran drinking alcohol and/or using drugs dependently and do not have access to medical/specialist support
  • Veterans needing access to BBV testing, vaccination or psychological work for needle fixation
  • Veteran with drug induced psychosis
  • Chaotic or complex drug/alcohol use, eg multi drug use, high risk factors including homelessness, no engagement with GPs
  • Intravenous drug use
  • Veterans seeking residential rehabilitation


Combat Stress is the UK’s leading charity for veterans’ mental health.

We provide life-changing treatment and support for veterans from every service and conflict. We focus on veterans with complex mental health needs that have arisen because of traumatic experiences while serving in the military.

We want to support veterans to recover from the impact of traumas experienced during military service, reduce symptoms and distress, and enable veterans to live the life they want based on their values and what is important to them.

We are a veteran-centric organisation. This means all staff receive training to understand military life and the mental health difficulties veterans can face after leaving the military.

We are also a research-led organisation. We have a dynamic research team that is part of national and international projects contributing to cutting-edge research in veterans’ mental health and innovations in treatment. Clinicians use this to continually improve our service’s effectiveness and ensure we deliver evidence-based treatments.

We only offer veterans treatments based on what we know works and that this has been shown in the research of high quality. Research, including our own, shows that veterans can recover from traumatic experiences, and it is right to be optimistic about treatment making a real difference to veterans’ lives.

As a charity we have over 100 years experience in the field of veteran mental health. We have developed collaborative partnerships with several statutory bodies including the NHSE, the NHS, MoD and the Scottish Government.

As experts in veteran mental health, we are well-placed to meet the changing needs of veterans today.

That is why we have developed our new VICTOR service – an intensive treatment for veterans with Complex PTSD.



  • A participant in the Royal College of Psychiatrists Quality Network for Veterans' Mental Health Services Peer Review
  • A finalist in the 2021 Royal College of Psychiatrists Team of the Year Award
  • A finalist in the 2021 Health Service Journal Military and Civilian Health Partnership Award
  • A member of the Confederation of Service Charities
  • A member of the Contact Group
  • A member of the Five Eyes international research collaboration
  • An internationally renowned research team
  • In a partnership with Virginia Mason Institute (Seattle, USA) to deliver Combat Stress' continuous improvement strategy

combat stress statistics
  • The Combat Stress Centre for Applied Military Health Research is part of national and international projects contributing to research in veterans' mental health and innovations in treatment. Our clinicians use this to continually improve the effectiveness of our service and ensure we are delivering evidence-based treatments.
  • The Centre was established in 2013 and is led by Prof Dominic Murphy. We are committed to publishing our research in external peer-reviewed academic journals as part of our commitment to contribute to the advancement of the veteran mental health field. We recently published our 180th paper.
  • Professor Murphy is also a co-Director at the Kings Centre for Military Health research at Kings College London. Our research department operates between the two organisations to ensure our research is of the highest standards.
  • Our research team investigates veterans' mental health needs, evaluates treatment outcomes and develops clinical services based on research findings.
  • Along with our Five Eyes allies in the US, Canada, New Zealand and Australia, Combat Stress is a world leader in veterans' mental health, at the forefront of developing, assessing, and introducing new and improved diagnoses and treatment of veterans' complex trauma-related mental health needs.

View our research library.