STATEMENT OF
PATRICIA RESICK, PHD
DIRECTOR, WOMEN'S DIVISION
NATIONAL CENTER FOR POST TRAUMATIC STRESS DISORDER
DEPARTMENT OF VETERANS AFFAIRS

BEFORE THE
SENATE COMMITTEE ON VETERANS AFFAIRS

HEARING ON MENTAL HEALTH ISSUES

April 25, 2007

I would like to thank the committee for the opportunity to discuss our program. I was asked to speak today on two topics. First, the national training initiative I am currently conducting to train therapists in an effective therapy for PTSD and the women's programs at VA Boston Healthcare System as an example of best practices for women veterans.

We have effective therapies, particularly cognitive behavioral therapies, such as cognitive processing therapy ( CPT), that can significantly reduce symptoms of PTSD and can cure it in many cases. Cognitive processing therapy, which I developed almost 20 years ago, is a 12-session treatment for PTSD which can be implemented in groups or individually. It has been shown to be effective for combat, sexual assault, and other traumas. Once cured, we have not found relapse in PTSD, over long periods of time that have been assessed in research (5-10 years). Therapies such as CPT for PTSD require one-hour weekly therapy for 13-14 sessions (including the intake appointments). In order to conduct this therapy, therapists have to be trained and provided support, such as case consultation with experts in the therapy. In order to implement CPT effectively, therapists should have no more than 25 cases in their case loads at any given time. VA Central Office has funded an initiative that I am conducting to train and support 600 VA therapists nationally in cognitive processing therapy. To this end, my colleagues and I have written a treatment manual with everything needed to conduct the therapy, and have trained qualified CPT trainers for two-day workshops and case consultation available 50 hours a week across the time zones. Over the next two years, we will be providing 22 workshops throughout the country followed by these support efforts.

VA Boston is a good example of best practices for services for women because, in addition to being able to receive services from any clinical program, women can receive services from specialized women's programs that represent a continuity of care. Like all VA hospitals we have a Women Veterans Program Manager and a Military Sexual Trauma ( MST) coordinator who serve as advocates for information and referrals to appropriate programs. We have a separate Women's Health Center that provides primary care, gynecological care, osteoporosis assessment and treatment, urgent care and social services. The Women's Stress Disorder Treatment team, located in its own wing of the hospital, offers outpatient mental health treatment for post traumatic stress disorder and other trauma-related mental health problems. A full line of services including psychiatry, individual and group therapy, psychological assessment and consultation are available. There is a separate wing of the acute inpatient psychiatric program designated for women to provide them security and privacy. We will soon open a residential program for women with co-occurring PTSD and substance abuse disorders. The goal is to help women develop skills to maintain abstinence, manage PTSD symptoms, and address their traumas. The program offers assessment; group, individual and psycho-pharmacological treatment and psycho-educational programs while supporting participants in the development of their own long-term recovery plan. The Women's Homelessness Program provides an array of services to homeless women and women at high risk for homelessness. Our transitional residence, TRUST House, specializes in the treatment of women with post traumatic stress, mood and substance use disorders. Up to seven women live in the residence. The treatment program involves individual therapy, case management, group therapy, house meetings, and paid work experience through the Veteran Industries Vocational Program. Women are assisted in making the transition from VA supported employment to employment in the community.

Thank you again, Mr. Chairman, for inviting me today. At this time, I will answer any questions you or other members may have.