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Couple/Family Therapy for Posttraumatic Stress Disorder: VA/DOD Clinical Practice Guideline Review

This article reviews the recommendations for couple/family therapy in the VA/DOD Clinical Practice Guideline for PTSD management, presents a heuristic for incorporating these interventions into Veterans' mental health services, and discusses recent research on couple/family therapy for Veterans with PTSD. The relevance of family relationships to PTSD symptoms and mental health problems is highlighted, along with the latest research on different couple/family interventions. The article concludes with the need for more research on optimal delivery modes for these interventions.

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Couple/Family Therapy for Posttraumatic Stress Disorder: VA/DOD Clinical Practice Guideline Review

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  1. Couple/family therapy for posttraumatic stress disorder: Review to facilitate interpretation of VA/DOD Clinical Practice Guideline Candice M. Monson, PhD; Alexandra Macdonald, PhD; Amy Brown-Bowers, MA

  2. Aim • Review couple/family therapy recommendations in Department of Veteran Affairs/Department of Defense (VA/DOD) Clinical Practice Guideline for Management of posttraumatic stress. • Present heuristic for incorporating couple/family interventions into Veterans’ mental health services. • Review recent research on couple/family therapy for Veterans with posttraumatic stress disorder (PTSD). • Relevance • Well-documented association between Veterans’ PTSD symptoms and family relationship and mental health problems.

  3. Heuristic for understanding target of different couple/family interventions for PTSD.

  4. Latest Research • Educational groups: • Associated with family members’ greater knowledge about Veterans’ mental health symptoms, VA resources, and decreased caregiver burden. • Generic behavioral couple/family therapy with Veterans and families: • 2 randomized controlled trials (RCTs) yielded improved relationship functioning but variable PTSD improvements. • Disorder-specific therapy: • Some data support efficacy in couples, but no group-level data yet for Veterans with PTSD. • Cognitive-behavioral conjoint therapy: • Uncontrolled trials and ongoing RCT indicate it ameliorates PTSD symptoms, enhances intimate relationship satisfaction, improves partners’ individual mental health and well-being.

  5. Conclusions • As we identify efficacious treatments, future dismantling studies may provide evidence of these interventions’ essential components. • More research needed on optimal delivery mode, for example: • Conjoint therapy delivered to individual dyads. • Group of dyads. • Via telehealth methodologies. • Paired with individual therapy. This article and any supplementary material should be cited as follows: Melcer T, Belnap B, Walker GJ, Konoske P, Galarneau M. Heterotopic ossification in combat amputees from Afghanistan and Iraq wars: Five case histories and results from a small series of patients. J Rehabil Res Dev. 2011; 48(1):1–12. DOI:10.1682/JRRD.2010.03.0033

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