PTSD/Trauma Recovery Services Clinic

Mark Barad, MD, PhD & Bruce Kagan, MD, PhD
Wed AM

The Trauma (TRS/PTSD) Clinic will give residents the opportunity to see returning Iraq and Afghanistan War Veterans for initial evaluations, medication management and exposure-based Cognitive Behavioral Therapy (CBT). Residents will evaluate incoming Veterans at the beginning of the year and then as necessary throughout the year. Residents will learn to complete both an unstructured and thorough clinical evaluation and the semi-structured CAPS (Clinician Administered PTSD Scale) interview. They will use CAPS to follow the progress of their patients in treatment. Each resident will treat a mix of "easy" and "difficult" patients over the year based on CAPS scores and comorbidities.

Residents will learn and deliver medication management and evidence-based therapies such as Prolonged Exposure Therapy (PE) and Cognitive Processing Therapy (CPT) to each patient, and learn how to adapt the manualized therapy to the needs of each individual and the exigencies of comorbidities.

Supervision will be provided by Drs. Barad and Dunn and 2 residents on Wednesday mornings, or Drs. Barad and Nurmi and 2 residents on Thursday afternoons along with specialized psychologists. Two additional residents will spend 6 months in the Trauma Clinic, and then 6 months in the Anxiety Clinic which operate side-by-side on Thursday afternoons. Many psychotherapy sessions will be directly observed using video conferencing equipment. Residents will leave the session to meet with a supervisor and discuss the case at some point during each patient visit.

Learning Objectives:

  1. To learn and perfect a thorough diagnostic evaluation including both informal screening interviews and structured interviews for Post Traumatic Stress Disorder (PTSD) and for common comorbidities including Depression, Bipolar Disorder, Generalized Anxiety Disorder, Panic Disorder and drug abuse.
  2. To learn the principles of medication management of PTSD as a paradigm for the treatment of anxiety disorders in general. To learn how to deliver effective exposure-based therapy and cognitive restructuring to patients with this
  3. treatment-resistant disorder. Learning to do good exposure-based therapy with combat PTSD patients will make other anxiety disorder psychotherapy relatively easy. Also, because psychotherapy for PTSD is often emotional and difficult (without having the manipulative aspects of treating borderline personality), it is a particularly good experience for a therapist to acquire emotional sea legs while keeping the therapy on course.
  4. To become familiar with the full range of literature about a psychiatric disorder where there is some knowledge of etiology and physiology.
  5. To learn how to generalize the principles of CBT for PTSD and the treatment of other psychiatric disorders.