Complicating factors associated with mild traumatic brain injury: impact on pain and posttraumatic stress disorder treatment

Observations and insights about strengthening our soldiers SOS

The Special Issue (June 2011) of the Journal of Clinical Psychology in Medical Settings titled Strengthening Our Soldiers (SOS) and Their Families: Contemporary Psychological Advances Applied to Wartime Problems revealed the following important concerns: 1) Who is at risk for psychological sequelae during and following service in the U.S. military? 2) How to deliver the best treatment for our soldiers and veterans with PTSD, Traumatic Brain Injury and Pain? 3) How to train the trainers? and 4) What are the current priorities for service delivery, research and funding? Assessment strategies and tools are provided to assist in identification of suicidal ideation and behaviors, alcohol abuse in spouses, posttraumatic stress disorders, depression, brain injuries and post-concussion syndrome, as well as positive growth experiences. Empirically validated Cognitive Processing and Prolonged Exposure treatments are described as are the empirical results already in evidence in our military populations. The innovative use of Virtual Reality and Telehealth applications is demonstrated in both army and naval settings for preparing and reducing trauma in affected soldiers. The Functional and Occupational Rehabilitation Treatment (FORT) Program and its role in returning function to injured soldiers with musculoskeletal pain and motion restrictions, while also leading to reductions of anxiety, depression and use of medical services, is described. A critique about providing service-research for children's reactions to their parent's deployments and family functioning during separation and reintegration is provided. The need for theoretical-empirical approaches to understanding pain-behavior, anxiety dysregulation as it impacts the brain function and structure is provided by experts in pain, neuropsychology, brain circuitry and anxiety management of multiple traumas. This final paper in SOS provides commentary on SOS and describes possible future implications of current psychological knowledge related to military personnel and their families.