I recently sat down with Dr. Alan Peterson, Consortium Director of STRONG STAR (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience), a multi-disciplinary, multi-site research consortium funded by the DoD and VA, to learn a little bit more about their current research projects. Dr. Peterson is a retired Air Force Lieutenant Colonel, a board-certified clinical health psychologist, and proposed STRONG STAR over five years ago to address the dearth of military-specific trauma research.
STRONG STAR is based at The University of Texas Health Science Center at San Antonio, although many research studies and investigators are located elsewhere. Its efforts focus on Post-Traumatic Stress Disorder (PTSD) and related problems among Service members and Veterans who have deployed in support of Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn. Studies continue to be developed, but current projects include a trial of massed treatment with Prolonged Exposure therapy (PE); an investigation of a brief PTSD protocol in a primary care setting; a comparison of group versus individual Cognitive Processing Therapy (CPT); a comparison of couples’ PTSD treatment with individual PE, and more. There are over 125 collaborating investigators at more than 20 partnering military, VA, and civilian institutions. Additionally, the STRONG STAR Consortium to Alleviate PTSD was awarded $45 million in August of this year to continue and expand upon their research.
Dr. Dolan: How did STRONG STAR get started?
Dr. Peterson: I had been active in research in the military, and worked over the years to collaborate on many grant proposals on military-relevant topics to study in a military setting. I approached the UT Health Science Center to work on grants and focus on research, as I was debating whether to retire from the Air Force and move to academia [or stay on active duty]. At dinner one night with my wife, I received a fortune from my fortune cookie that read: “Don’t be afraid to take that big step.” I eventually decided to retire and focus on research. At the time, the things we were proposing were a jump ahead of the science. Then in 2007, Congress set aside $300 million for research, so I thought, “Who are the top researchers to focus on PTSD research?” We had a big meeting, worked with collaborators including Dr. Edna Foa and Dr. Dave Riggs, and pulled a team together. Our final submission was 1300 pages. The key was the focus on active duty and military populations, and bringing in civilian expertise. Very few sites do that.
Note: Dr. Peterson still keeps the fortune in his office. The submission was awarded a $35 million grant from the DoD in 2008, and STRONG STAR was established.
DD: What are the goals of the consortium?
AP: To develop the most effective assessment, detection, treatment, and prevention programs for combat-related PTSD and other disorders in active duty and Veterans.
DD: What have been some of the seminal findings of research under the Consortium?
AP: Most of the research is still ongoing. Our first published study was a pilot study of PTSD treatment in primary care. We found we can get good outcomes with an abbreviated model.
DD: How can clinicians stay updated on STRONG STAR’s research findings?
AP: We have a website, www.StrongStar.org. We have listings of published manuscripts and studies. We’re presenting at the Association of Behavioral and Cognitive Therapies and International Society for Traumatic Stress Studies conferences. Once we have formal findings, we will funnel them through the Center for Deployment Psychology and the Defense Centers of Excellence for dissemination.
DD: What is in store for the future of the consortium?
AP: We’ve partnered with the VA, who will fund 2/3 of the research moving forward. We will identify research gaps that exist and every six months propose studies that will allow us to be on the cutting edge. Also, there will be an emphasis on physiological markers for the detection of PTSD and identifying which treatment a person would respond to best. For example, we will look at a blood test for PTSD, which one of our collaborators believes may allow for up to an 80% sensitivity, 85% specificity to better detect PTSD. We will also continue our original research studies, as our original award has been extended.
DD: What are some things a clinician in the field can take home from the consortium’s work?
AP: One of the things we’ve found is that standard, evidence-based therapies for civilian populations need some tailoring to allow them to work in a military setting. They are not a “plug and play.” [The question is] what do we need to do to enhance outcomes in this setting, make those treatments work?
The biggest take-home message here is that there is a general consensus among patients, providers, and the public that PTSD is a chronic, lifelong disorder. However, we strongly believe PTSD is treatable to the point of having productive lives, reduction, and remission of symptoms, that PTSD has very effective treatments.
As you can see from Dr. Peterson’s interview and the research so far on PTSD, the good news is that not only do current effective treatments exist, but ongoing research by the consortium will help target and enhance these treatments. If you are interested in learning to provide effective, empirically supported PTSD treatment, including Prolonged Exposure and Cognitive Processing Therapy, the CDP offers a number of trainings, with more information under the “Training” tab of our website. In the meantime, stay tuned for future STRONG STAR research findings!
Please note CDP’s Executive Director Dr. David Riggs is co-investigator for one of STRONG STAR’s studies on conjoint couples’ therapy for PTSD. Additionally, Dr. Dolan is a study clinician and associate investigator for one of STRONG STAR’s studies on treatment of PTSD in an integrated primary care setting.
Dr. Dolan is a Deployment Behavioral Health Psychologist with the CDP at Wilford Hall Ambulatory Surgical Center.