When I got married, my bridal shower hostess asked for my guests to give my husband and me advice on having a happy marriage. This wisdom ranged from “Never go to sleep angry” to “Remember that being happy is more important than being right.” All of this seemed to be good, sound advice for a couple who came into the relationship a bit later in life, after we had dealt with most things from our pasts. However, this got me thinking, “What happens to our Service members and Veterans and their significant others when they are unable to put the past in the past due to the multiple stressors of military life and exposure to traumatic events?”
While the vast majority of Service members exposed to traumatic events and stressors while deployed and in garrison naturally recover from these experiences, some will have persistent symptoms and develop Posttraumatic Stress Disorder (PTSD). For a review of the DSM-5 changes to the criteria for PTSD, see the American Psychiatric Association website here.
Military members are at greater risk of developing PTSD, largely, because they are exposed to traumatic events at a higher rate than their civilian counterparts. As mental health providers, we often offer effective, evidence-based individual therapy treatment options for PTSD such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). However, these treatments target the individual with minimal to no involvement from the Service member’s significant other (or close family member, such as a parent). Due to this, individualized treatments can sometimes feel incomplete as we know that PTSD does not just affect the individual, but impacts the whole family. When the Service member is simultaneously struggling with PTSD and serious relationship problems, we may want to consider another form of therapy, Cognitive-Behavioral Conjoint Therapy for PTSD (CBCT-PTSD). CBCT-PTSD, developed by Dr. Candice M. Monson, is an evidence-based manualized therapy consisting of 15 treatment sessions, each 75 minutes in length, with the simultaneous goals of improving individual PTSD and enhancing intimate relationship functioning.
CBCT for PTSD involves both the Service member and a significant other. It provides a way for people to make use of their social support to get through treatment which has two benefits: 1) it capitalizes on the relationship to make the individual better, and 2) it helps improve interpersonal relationship, which are frequently impacted by PTSD.
While working with Service members, I have utilized CBCT-PTSD and found it to be very helpful. Through CBCT-PTSD, the significant other gains a much better understanding of what PTSD is and the treatment for it because they are deliberately integrated into the therapeutic process. In fact, Service members shared that they were more likely to reach out to their significant other for support between sessions during CBCT-PTSD because they would understand how to help them.
What advice would I give to Service members and Veterans and their significant others who are struggling? If you think there might be signs of PTSD, seek out professional help. Also, relationships are hard work, and when PTSD is present it is much harder. Many Service members and Veterans struggle with both relationship issues and PTSD.
What advice can I offer my fellow mental health providers? It is our job is to keep expanding our knowledge-base and skill in treating the concerns of Service members and Veterans. To assist with this, I have provided a number of resources below for further information and training opportunities. Check them out!
For additional information about CBCT-PTSD or to inquire about getting trained, visit the website here.
Mark your calendars for 17 May 2018 from 1000-1700 EST, you’ll want to sign up for the Center for Deployment Psychology Couples’ Webinar Series. The links to each webinar follows:
Military and Veteran Couples: Elements of the Assessment Process
Military and Veteran Couples: Evidence-Based Approaches to Treatment
An Intervention Model for Working with Military Couples Who Have Experienced Infidelity
To obtain training in Prolonged Exposure for PTSD, Cognitive Processing Therapy for PTSD, or other evidence-based training, please go to the
CDP's Upcoming Training Calendar here.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Erin Frick, Psy.D., is a clinical psychologist and Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences. Dr. Frick is located at Travis Air Force Base in Fairfield, California.