Continuum of Care: Moving Health Services from DoD to VA

Contributor:  Carie Rodgers
Posted:  09/20/2012  12:00:00 AM EDT
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One of the challenges of Veteran healthcare is the smooth transition of men and women from the DoD to VA health services. According to Dr Carie Rodgers, Associate Director, VA Center of Excellence, “we are working very hard to make sure returning military members know about VA services and know how to access those services”. This IDGA exclusive examines the latest updates and advancement being explored for the future of healthcare for Veterans, including the ability to reach Veterans in rural areas of the United States. Read on…


IDGA: Highlight for us the recent updates or advancement being learned at the VA Center of Excellence for Stress and Mental Health.

We do a lot of research.  One of the larger projects at the Center is being done in collaboration with the Department of Defense.  One of our investigators, Dr. Dewleen Baker, is looking at risk and resilience, so what kind of things predict folks having difficulty on deployment and after they return home, and what sort of things predict people doing very well during deployment and upon their return home.  Dr. Baker is working with the Marine Corps to assess Marines before they leave for deployment and then assess them upon their return and follow them up later to see how they are adjusting.  Ultimately this work should help us start to understand how to help military members before they leave for deployment so they have fewer difficulties after they return home.

We’re also involved in looking at innovative ways of doing psychotherapy with veterans.  The VA serves many, many veterans in rural areas around the country who don’t always have easy access to healthcare.  To address the needs of rural Veterans, the VA has been the leader in implementing telemental health services.  Dr. Steven Thorp, a VA investigator at CESAMH, has a couple of projects examining how effective psychotherapy is when you do it over a computer screen as opposed to doing it in person. This is a promising technology that may help us serve our countries Veterans more effectively.


IDGA: Do we know more nowabout how to treat PTSD for returned servicemen and women, as opposed to five or ten years ago, and how so?

The VA is a leader in conducting research and implementing psychotherapies for Post-Traumatic Stress Disorder and Traumatic Brain Injury.  Many studies have been published in the last decade looking at veterans’ mental health and their responses to treatment for Post-Traumatic Stress Disorder as well as TBI and other stress-related illnesses.  The VA has disseminated evidence-based care for veterans around the country, at all VA medical centers.  We are always working to do those things better, and to provide stronger, more evidence-based services for veterans around the country.


IDGA: Could you explore for us the range of rehabilitation techniques being applied to patients suffering from stress and PTSD?  Now do you treat them differently, you know, people with stress verses PTSD?  How so and in what ways?

We certainly meet our veterans where they are and we assess every person as an individual. We work with every veteran who comes through our doors to identify the treatment goals and the needs that they identify.  The VA is very committed to being veteran-centered; we provide many treatments for veterans who are suffering as a result of stress, traumatic brain injury or exposure to other kinds of traumas.  We offer multiple evidence-based psychotherapies including exposure therapy and cognitive-based therapies.

We also provide assistance with relearning for folks who have cognitive difficulties after TBI.  Treatment can help Veterans relearn skills of organization and planning which can enhance memory when they’re having difficulties. This type of rehabilitation helps people get back to work or school and become more involved in their communities.  It helps build stronger relationships with their families and friends. 

We offer a wide range of services and we certainly meet people where they are.  If a Veteran comes to the VA with a diagnosis of PTSD, we work with them to create a treatment plan. If they come in with stress related issue, but not necessarily a diagnosis of PTSD, we’re going to work with them to evaluate their individual needs are and work together to create a plan that can best help them move forward in life.


IDGA: What challenges or issues do you think exist within this continuum of care for returning veterans?

The VA is continuing to work on smoothly transitioning folks from the Department of Defense into the Department of Veterans Affairs for their healthcare.  We are working very hard to make sure that returning military members know about VA services and know how to access those services. We want Veterans to know  that they are welcome here, that we offer some of the best care in the nation, and that we are here to serve them.  I think one of our big challenges is to make sure that message gets out, and make sure that we are getting veterans who need healthcare into our facilities.


IDGA: Are there new or evolving technologies or treatments that you are excited about for the advancement of veteran healthcare?  Talk to us a little about that.

Sure, there are a few things that I’m really excited about.  The VA’s been involved in examining the effectiveness of using virtual reality in the treatment of Post-Traumatic Stress Disorder for veterans, and there’s more and more research being done on that. 

Dr. Sonya Norman, an investigator at the VA Center of Excellence for Stress and Mental Health, has been involved in developing and evaluating new treatments for people who have PTSD or stress-related disorders as well as abusing drugs or alcohol.   Developing treatments that can help folks who have multiple stress-related or trauma-related problems at the same time is an essential next step in our research efforts. 


Dr Rogers:“I have been with the VA since 1999. During that time I have worked in a number of settings, but most of my career at the VA has been working with veterans who have experienced some sort of trauma in their life, usually during their military service.  I used to be the Director of the Military Sexual Trauma Program at the San Diego VA, where we focused on treating veterans with difficulties after experiencing sexual assault or harassment during their military service. Currently I train VA clinicians around the country to treat PTSD with evidence-based psychotherapies”

Carie Rodgers Contributor:   Carie Rodgers

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