Alcohol-related aggression: New therapies may result from Ohio State study
The Ohio State University Wexner Medical Center recruits national expert to lead research and treatment programs for PTSD and suicide prevention
As a national leader in suicide prevention and post-traumatic stress disorder (PTSD) treatment, the Suicide and Trauma Reduction Initiative for Veterans (STRIVE) has moved its programs and research to the Ohio State Wexner Medical Center. Founded in Utah by program director Craig Bryan, PsyD, ABBP, STRIVE has plans to expand its programs to diverse and underserved populations across the country.
Among STRIVE’s successes is a two-week R&R intensive treatment program for veterans with PTSD. Since its start in 2013, the program has helped more than 75% of participating veterans resolve the effects of PTSD by the end of the two-week program. More than half of the participants maintain improvements when re-evaluated six months later. During the COVID-19 pandemic, participation takes place via telehealth.
Dr. Bryan thinks a key to the program’s success is that its concentrated format is uninterrupted by responsibilities and distractions of everyday life. Participants are more likely to stick with the program, as they meet virtually with clinicians every morning for cognitive processing therapy for PTSD. They have afternoons free to pursue their own activities and work on newly acquired skills.
“With this trauma-focused therapy, we go right to thought processes and emotions of a person’s trauma,” Dr. Bryan says.
The program is supported by a grant from the Boeing Company, so there is no fee for participants. Those interested are evaluated and, if accepted, start the program with little or no delay. Dr. Bryan hopes to accept 100 to 150 veterans into the program annually.
Crisis Response Planning reduces suicidal behavior by 60%
Another important initiative Dr. Bryan is introducing at the Ohio State Wexner Medical Center is a 30-minute suicide prevention intervention called crisis response planning (CRP).
CRP, a technique Dr. Bryan has helped refine, focuses on guiding patients in creating their own plan to take action against suicidal thoughts. Both health care providers and non-clinical individuals can be trained to facilitate a conversation with an at-risk person about stressors, feelings and what works to reduce stress. The individual then receives an index card and handwrites the plan on the card with guidance from the facilitator. The plan is a checklist that outlines personal warning signs, coping strategies, and how to activate social support and access professional crisis services.
“CRP significantly reduces suicide attempts, suicide ideation and psychiatric hospitalization among high-risk people,” Dr. Bryan says. “It’s an empirically supported intervention that my research team and I showed reduces suicide attempts by 76%.”
A clinical trial he led demonstrated CRP’s superior effectiveness with soldiers, as compared to the widely used no-suicide contract. The study supported CRP’s effectiveness even six months after the intervention.
The simplicity of CRP makes it easy to implement in emergency departments, primary care offices, outpatient mental health and inpatient psychiatry settings. Dr. Bryan has developed a training curriculum for both military and non-military settings.
He will soon be piloting a newly developed app for military personnel and veterans who are struggling with suicidal ideation. A smartphone version of brief cognitive behavioral therapy for suicide prevention (BCBT), the app offers a 12-session therapy program that Dr. Bryan has shown can significantly reduce suicide attempts among both military personnel and civilians. The app includes CRP, but it also contains additional video content and other features designed to teach the core concepts of BCBT. He says it’s a way of helping those who are unable or unwilling to see a therapist.
“It’s like a therapist in their pocket. We teach people to recognize their own emotions and then what to do about it,” Dr. Bryan explains.
Dr. Bryan, a veteran of the Iraq War, says he has a personal commitment to the veteran community. He also wants to expand STRIVE and CRP as potentially lifesaving treatments to other groups at high risk for PTSD and suicide.
For more information, call Dr. Bryan at 614-366-2314 or email him at craig.bryan@osumc.edu.
