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VETS WELCOME RETURN OF DISCONTINUED THERAPY

GROUPS AT LOMA LINDA VA -- A group of older military vets

say they are pleased to hear the long-term therapy group they

had come to rely on for treatment of PTSD is being reinstated.

Jeff Haines, left, here with fellow veterans Floyd Brooks, center, and Bill Roy, circulated a petition that sought the reinstatement of the discontinued therapy sessions. (photo: Kurt Miller / The Press-Enterprise)

For more about veterans and PTSD, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=ptsd&op=and

Story here... http://www.pe.com/localnews
/inland/stories/PE_News_Local_S_vets04.2e780e3.html

Story below:

-------------------------

Veterans welcome return of discontinued therapy groups at Loma Linda's VA hospital

By MARK MUCKENFUSS
The Press-Enterprise

A group of older military veterans say they are pleased to hear the long-term therapy group they had come to rely on for treatment of post-traumatic stress disorder is being reinstated at the Jerry L. Pettis Memorial VA Medical Center in Loma Linda.

The veterans say their groups were abruptly discontinued earlier this year.

A petition signed by 47 of the affected veterans was filed with the hospital in February protesting the elimination of therapy groups. Some had been taking part in the groups for more than a decade.

Jeff Haines, the Vietnam veteran who circulated the petition and presented it to hospital administrators, said he and his fellow veterans found the group therapy sessions to be a safe haven where they could connect with others facing the same kinds of problems, overcome some of their fears and share strategies for handling anger, stress and other issues. Haines said he and many others feel the hospital had callously eliminated a critical support mechanism in their lives and turned a deaf ear to their concerns.

"Their new approach is, 'Get over it,' " Haines said. "All it's doing is getting guys to give up."

The conflict comes at a time when those who study mental health issues say the Department of Veterans Affairs' hospitals need to be gearing up for an influx of post-traumatic stress patients as veterans of the wars in Iraq and Afghanistan leave the service. A study by the RAND Corp. released earlier this year estimated that 300,000 military personnel serving in those conflicts may have post-traumatic stress issues.

Officials at the VA hospital said the closure of the therapy groups was part of a shift toward more directed programs designed to better help patients.

"No groups were really discontinued," said Lois Krawczik, a psychologist who oversees post-traumatic stress programs for the hospital. Instead, she said, the concerned patients were directed to newer programs that include 12-week classes based on a 12-step recovery model and peer-facilitated counseling. "We never stop a group and tell people, 'Good luck. Go away.' "

But the situation is not isolated. Veterans involved in at least three separate therapy groups at the Loma Linda hospital said their groups had also been terminated.

In May, veterans said they had been informed their therapy group at a veterans clinic in Victorville was being discontinued. They say the VA reversed that decision after they contacted lawmakers and the media. Krawczik said the situation was a misunderstanding and there were no plans to end the group.

New Therapies

But, she said, there is a shift in the field of treating post-traumatic stress as new "evidence-based" therapies are introduced. Some of the new therapies include prolonged exposure, where patients learn to deal directly with situations that trigger stress, and cognitive-processing therapy, which teaches patients to retrain their responses to those same triggers. Krawczik said she and others believe these new therapies are more effective than traditional group therapy.

"It's a national understanding," she said, "and, I would say, amongst our staff and the ones knowledgeable about that (it is also understood)."

A story issued by the VA's headquarters in July said both prolonged-exposure and cognitive-processing therapies were more effective than medication, but it did not mention traditional group therapy. Few post-traumatic stress experts advocate medication by itself as an effective treatment.

But experts in the field say traditional group therapy can serve as an integral and useful part of treatment for post-traumatic stress disorder.

Capt. Edward Simmer, M.D., senior executive director for psychological health at the Army's new Defense Center of Excellence for Psychological Health and Traumatic Brain Injury in Maryland, said it is too soon to tell which treatments are best.

"At this point there is not sufficient research to determine if this more focused method is more effective," Simmer said in an e-mail. "Group therapy can be part of a successful treatment program when it is used as one component of an overall treatment plan."

A May 30 memorandum from Michael J. Kussman, the undersecretary for health, directs VA hospitals that have discontinued group therapy programs to reinstate them.

"Existing treatment strategies have provided comfort and relief for some older veterans who have suffered for many years," he wrote. "We must augment those treatments, not replace or eliminate them."

Pleased But Skeptical

Haines said he has been told that the group he belonged to is scheduled to start up again next week. He's pleased that the move is being made but remains skeptical about what restrictions might be placed on the group members.

Larry Holmgren, 77, was in the same group as Haines. A veteran of the Korean War, Holmgren was diagnosed with post-traumatic stress disorder in 2003. The therapist who diagnosed him practically dragged him into a group session, he said. He came to rely on it.

"There's really no cure for what we have," Holmgren said. "But there are ways to deal with it, and we learned that every day when we got together. We have that bond we've developed between us. We want the right to be together to continue our treatment."

He said he has felt less able to cope without the group's support.

"I love the guys because they help me function more properly," he said. "You can regress when you don't have the support of the group."

Like Haines, he said he will take a wait-and-see approach to the restarting of the group.

"We have been led down the primrose path quite a few times so we'll see how it turns out," Holmgren said. "But we'll give (the therapist) our full cooperation. We're hopeful."

Both Holmgren and Haines also raised concerns about access to care. They don't feel the mental health department is adequately staffed and said they have observed a high turnover in personnel.

Another group member, Phillip Reams, 63, of Cherry Valley, has similar concerns.

"There are areas in this VA where you could not get any better care anywhere," Reams said. "But when it comes to the mental health department, it drops off severely in terms of the quality of care."

Reams was one of several veterans who complained about the frequency with which they were able to see either psychiatrists or psychologists or both. In his case, Reams said, since the group was dissolved in February, he had gone from getting therapy weekly to seeing a psychologist once a month.

Gilbert Mink, 40, of Redlands, has experienced a high turnover in the doctors providing him with medications to treat his post-traumatic stress symptoms.

"Every three months, I would get a new psychiatrist," Mink said. "I'd see someone once a month for three months, then get someone new. I never knew if they were going to completely change my meds."

Despite a large budget increase last year, sources say the mental health department is understaffed and struggling to meet patient needs.

Bill Roy, 53, of Winchester, is a veteran of both Vietnam and Afghanistan. He said if he wants an appointment with his psychiatrist, it's a 4 ½- month wait.

Instead, Roy said, "He talks to me after hours on his own nickel or he squeezes me in on his lunch break. I try to get to him about every four or five weeks. It's been about nine weeks now because a bunch of (psychiatrists) quit."

Krawczik does not oversee the psychiatric staff, but she said she was unaware of any shortage or access problems for patients. She said mental health programs are expanding, with larger physical facilities planned for existing clinics in San Bernardino and Victorville.

"We are always looking at ways to improve access to care," she said. "There likely will be continued growth. There is supposed to be money for additional staffing."

As to reinstating the hospital's post-traumatic stress therapy groups, Krawczik said that despite the delay, 10 to 12 therapy groups are in the process of being re-established.

Benjamin Goodwin, 63, of Yucaipa, said he was told the therapy group he'd met with since 1993 will restart in September.

Having the group cut, he said, "was like being disrespected again, like when we came back from Vietnam. It was like (being) cut loose from the herd."

Goodwin wrote letters to hospital administrators about his concerns. He's pleased to see a reversal in policy.

"I look forward to it," he said. "I look forward to helping my brother veterans. I use this as an outlet. Every week when I go, I feel cleansed. I feel renewed."

Reach Mark Muckenfuss at 951-368-9595 or mmuckenfuss@PE.com

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posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

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