Motivational Interviewing May Benefit Recent Vets
> 9/13/2007 1:20:28 PM

A new study being conducted at the San Francisco VA Medical Center (SFVAMC) will focus on helping veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) seek early treatment for mental disorders. We can all hope that this population, which has a high risk for developing mental problems related to the traumatizing effects of war, will receive the assistance it needs. According to the United States Department of Veterans Affairs (VA), 12-20% of soldiers and Marines suffered from post-traumatic stress disorder (PTSD) after returning from Iraq, 7-15% experienced depression, and 1 in 4 used alcohol more often than they would like. In a previous study, Dr. Karen Seal found that 31% of Iraq and Afghanistan veterans had some sort of mental health problem, with younger veterans (aged 18-24) five times more likely to develop PTSD. Although mental illness affects so many veterans, many are reluctant to seek treatment, often because of the logistics involved and because of fears that others will perceive them as weak.

The VA has already taken a number of steps to ensure that veterans have access to mental health services, including free health care for veterans suffering from a war-related injury or illness and access to a special clinic that combines primary care, combat stress services, and social services and which was specifically designed for OIF and OEF veterans. The researchers at SFVAMC, headed by Dr. Seal, hope to further improve treatment options and outcomes by evaluating the effects of motivational interviewing, a therapeutic process that addresses barriers to mental health care. Dr. Seal explains that "interviewers will work with veterans to figure out ways in which they can more easily access care, and how they might be able to cut through some of the red tape that they perceive to be there, or that may actually be there, to get the services that they need."

The researchers will use a telephone screening process to identify OIF and OEF veterans suffering from PTSD, depression, substance abuse, and traumatic brain injury (TBI). They will then randomly assign the veterans to either motivational interview sessions or standard informational support sessions in which the veteran will be given information about their disorder. All sessions will be conducted over the phone. At one, three, and six months the researchers will evaluate whether or not the veterans engaged in treatment for a mental disorder, if their symptoms have lessened, and if their overall quality of life has improved. If motivational interviewing works more effectively than the informational support sessions, the technique, which can be taught in only a few days, can be implemented throughout the country.

Early treatment is important when treating mental health problems, and motivational interviewing is just one more tool we can use to help veterans get help as soon as possible. Dr. Seal notes that this technique can "provide care givers new ways to intervene early so that veterans of Iraq and Afghanistan don’t develop the chronic difficulties and disabilities we’ve seen with Vietnam-era veterans." With motivational interviewing, we may be able to prevent an epidemic of veterans with trauma-related mental health problems.

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