USF study of innovative therapy for PTSD expands to military sexual trauma

The USF College of Nursing leads research on a novel technique to alleviate veterans’ symptoms of combat-related and military sexual trauma. 

By Saundra Amrhein
On a recent spring morning, Artricia James-Heard walked into the office of a therapist trained in an innovative technique being studied by researchers at the University of South Florida.

Upon entering, James-Heard, a Navy veteran who had been sexually abused in the military, was a woman prone to nightmares. To sleepwalking onto the front porch where her own screams would wake her. To hallucinations, a short temper and a general malaise that often left her yelling and angry at her husband and children.

But that day when she walked out of the office, a fog had lifted. She could breathe easily for the first time in years. She saw clearly – as if her brain had been cleansed like the windshield of a car going through a carwash and scrubbing – both inside and out. In the days and months to come, she slept soundly, regained lost energy – and became the loving mother and wife she always longed to be.

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Navy veteran Artricia James-Heard with her youngest son Devean, 11.

“They gave me my life back,” James-Heard said of the treatment and research.

That treatment – called Accelerated Resolution Therapy, or ART – has been under study at the USF College of Nursing for more than four years, showing remarkable results among initial participants, namely military veterans and civilians with symptoms of depression and post-traumatic stress disorder, or PTSD.

Since the inception of the first study in 2010 under  lead investigator, Dr. Kevin Kip, executive director of the USF College of Nursing Research Center, the ART research has branched out. From focusing on combat-related trauma among active duty and military veterans, it now includes those who have been traumatized by sexual violence in the military. Meanwhile, through the training of professional therapists and service providers, the benefits and relief of the therapy are spreading to thousands of veterans and service members across the country.

“The need for this kind of therapy is great,” said Diego Hernandez, clinical director of the ART research program at USF. “The potential for ART is tremendous.”

Now considered an epidemic in the United States, PTSD is particularly prevalent among military veterans and service members – ranging up to 30 percent of Veterans Administration patients who served in Iraq and Afghanistan.

What’s more, the New York Times reported in 2012 that the rate of suicide among active-duty military personnel eclipsed the number of troops dying in battle.

But another cause of PTSD in the military, according to the Department of Veterans Affairs, is military sexual trauma (or MST). It estimated that of veterans who use VA health care services, nearly a quarter of women reported sexual assault while in the military. More than half of women and more than a third of men reported experiencing sexual harassment while in the military.

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Counterclockwise from upper left:  Artricia James-Heard with son Matthew, 14; husband Michael, retired Navy Master-at-Arms; daughter Michelle, 16; and son Devean, 11.

Hernandez suspects that a large number of MST victims don’t seek treatment because of the military’s insular culture and the past nature of its chain of command in reporting complaints – particularly when those responsible to address sexual misconduct are the perpetrators.

The effects of previous stress or combat-related trauma can be compounded by sexual trauma and the silence that surrounds it.

USF researchers are reaching out to MST victims as part of the most recent stage of their ongoing study of ART in efforts to have the therapy officially classified as an evidence-based treatment for PTSD. An earlier stage of their research that included civilian victims of sexual assault, as well as military veterans and active-duty service members, showed very positive results after two to five sessions of ART.

The premise of ART hasn’t changed.

It works though two steps: the first is imaginal exposure where the relaxation response is provoked by having the patient continuously move his or her eyes from left to right, following the movement of the therapist’s hand, while the patient imagines traumatic experiences free of verbalizing the details.

The memories trigger physiological reactions, such as an increased heart rate and sweating, and each distressing symptom is addressed until relief is experienced. Next the therapist asks the patient to reimagine the experience, only now instead of facing the onslaught of fearful sensations and helplessness, the patient reorders the memories with the aid of constructive and positive thoughts.

Researchers are still not quite sure how, but the act of performing horizontal eye movements during therapy helps the brain return to a healthy processing of memory – like organizing files in a file cabinet. It rescripts the memory and allows for clear recall of the event but now with the body in a relaxed state.

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Diego Hernandez (left), clinical director of the ART research program at the USF College of Nursing, demonstrates the technique of accelerated resolution therapy.

“It allows the brain to process all the components of a memory such as the images, sensations, feelings and thoughts on a deeper level and move it to the past where is it no longer experienced with distress,” Hernandez said.

And unlike traditional lengthy therapies that have been used to treat military veterans with PTSD, it requires little verbalization that belabors the details of excruciating memories, no homework, no medications and – very importantly – is showing improved sleep and drastic reduction of PTSD symptoms in just two to five sessions.

“The traditional methods aren’t addressing the particular needs of our combat veterans with multiple deployments and constant engagements,” Hernandez said.

Researchers from USF have been training mental health professionals in ART at Fort Benning, Georgia, including at the Ranger Performance Enhancement Center; at Fort Belvoir in Virginia; and will do so in April at the Walter Reed National Military Medical Center in Maryland.

Locally there are four USF ART study locations throughout Central Florida where ART therapy is being conducted and data collected. That includes locations in Orlando, Clearwater, and two in Pasco County – the Pasco County Jail and the Veterans Alternative Center.

“At USF,” Hernandez said, “we are training therapists and collaborating with other independent researchers and if the findings remain consistent, ART has the potential to change the way psychotherapy is done, particularly with our service members who would not have to live with events for years, only to receive help once things have become progressively worse.”

“Imagine a world,” he added, “where mission debriefings could be followed by ART to discharge the physiological intensity of combat, so that our service members can come home with the same clarity and purpose with which they served.”

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James-Heard says the ART she received at USF eased her debilitating symptoms and helped restore her energy. Here she tries her hand at making pasta during a local Wounded Warrior Project health and wellness event.

James-Heard received ART in Tampa through therapist Mireya Martin, who has been a part of the studies conducted at USF.  In follow-up sessions over the course of a year she continued to see a transformation in many areas of her life – including with family relationships and career goals. She now runs her own credit-counseling business and was invited to contribute a chapter to the second edition of a book called “Transform Your Life.”

With her mind clear and relaxed, she can focus on the present – and the future.

“It’s so possible,” she said. “I’m living proof of it.”

That similar shift has been life-saving for other military veterans like “Dave,” a 30-year-old former Army Ranger. For years, he was haunted by flashbacks and nightmares. He would be going about his day when suddenly an image would intrude – one of many faces of someone he had worked on as a medic during more than 30 military missions to the Middle East the past 10 years.

For nearly that long he sought relief through traditional talk therapy, took prescription medications for panic disorder. Nothing worked. Then one day, to stop the relentless torment in his brain and pain in his body, he brought a razor to his wrist and tried to kill himself.

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Kevin Kip, PhD, executive director of the USF College of Nursing Research Center, leads the USF studies investigating accelerated resolution therapy, or ART.

After Dave’s suicide attempt, a buddy drove hours to see him. Trying to save his life, he told Dave about the ART study and program at USF.  A nonprofit organization near Dave’s hometown paid to fly him to Tampa to participate in the study and undergo ART treatment with Dr. Hernandez.

Dave finally found the relief he sought for a decade. For the first time in years, he has been sleeping soundly and focusing on something other than his recurring trauma. He is looking forward to the next stage of his life, considering returning to Tampa to seek a nursing degree at USF. He hopes other Rangers and military veterans who either avoid or drop out of other lengthy therapies can find ART to help stop years of needless suffering.

“If it wasn’t for a friend of mine driving up to tell me about this,” Dave said of ART, holding up his deeply scarred wrist, “I wouldn’t be here.”

Photos courtesy of Artricia James-Heard and the USF College of Nursing.

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