Front & Center with Dr. Deborah Beidel

This week, I’ve been covering resources available to those coping with Post Traumatic Stress Disorder (PTSD). I’ve featured non-profits offering free counseling, as well as websites and apps offered by the Veterans Administration and the National Center for Posttraumatic Stress Disorder. Today, I have the privilege of interviewing Dr. Deborah Beidel, who is going to tell you about yet another resource, and one that I find very interesting and I think you will, too.

Dr. Beidel, PhD, ABPP, is an award-winning clinical psychologist and educator. Since earning her PhD in 1986 from the University of Pittsburgh, she has held a number of prestigious positions, including Chair of the American Psychological Association’s Committee on Accreditation and Editor in Chief of the Journal of Anxiety Disorders. She is currently serving as the Pegasus Professor of Psychology and Medical Education at the University of Central Florida (UCF) and Director of UCF’s RESearch and Treatment On Response to Extreme Stressors (RESTORES) clinical research center. As such, she oversees UCF’s Trauma Management Therapy Program, which treats veterans with PTSD, and is funded through a research grant from the Military Operational Medical Research Program.

Today, Dr. Beidel is going to answer a few questions about the components of UCF’s Trauma Management Therapy (TMT) Program, why it’s so effective, and how veterans struggling with PTSD can participate in the program.

1) The Trauma Management Therapy Program combines individualized exposure therapy with group therapy sessions to form one complete therapy plan. How does combining these two types of therapy increase the chances of mitigating PTSD symptoms?

Trauma Management Therapy is designed to be a comprehensive treatment for PTSD. Specifically, exposure therapy, with virtual-reality augmentation, is designed to target the arousal symptoms of PTSD, such as increased anxiety, hypervigilance, and sleep disturbance. The group therapy component is designed to target other symptoms such as anger, social avoidance, and depression. The combination of individual and group therapy leads to decreased PTSD symptoms as well as decreased anger and depression, and increased social activity.

2) The individualized exposure therapy recreates a traumatic event for the veteran using customized visual, auditory, tactile, and olfactory stimuli – essentially four of the five senses. Could you explain how this is done?

During the assessment, details of the traumatic event are obtained and the therapist creates a written scene to present during the exposure sessions. The scene may include visual, auditory, olfactory, and/or tactile information that is part of the memory. It is important to use as many modalities as possible to increase the veteran’s ability to “immerse” in the scene. The sensory information is controlled by software and the therapist selects the sights, sounds, and smells on the computer keyboard. The sights are presented through a head-mounted display, the sounds through headphones, and the scents through a machine that is powered by an air compressor. The tactile stimuli are produced by subwoofers under the chair/platform in which the participant sits during therapy. As an example, if the scene involves a Humvee explosion on a night mission, the therapist may present a visual that involves darkness (perhaps viewed through night vision goggles), sounds of the explosion, smells of diesel and smoke, and the chair the veteran occupies will rumble.

3) Seven years after returning, the scent of hand sanitizer still conjures images of Afghanistan for me, so I am particularly intrigued by the use of odors in the exposure therapy. What are some of the smells used in the therapy and why is this part of process so essential?

The use of smells to augment exposure therapy is particularly useful as memories are tied directly to the amygdala, a part of the brain that processes emotion, and the hippocampus, which is responsible for associative learning. The olfactory bulb has direct access to these parts of the brain. When you first smell something, you link it to a person, place or event and your brain forges a link between smell and memory. When you smell the scent again, the link is already there and your brain connects it to a memory or mood state. As an example, you may think of Grandma and feel happy when you smell chocolate chip cookies baking. With veterans and memories of combat, smells of diesel exhaust or smoke from a barbeque may trigger traumatic memories. The odors most commonly used in therapy include diesel, cordite, body odor, garbage, and burning rubber.

4) There seems to be a stigma amongst military veterans concerning seeking therapy, especially with the idea of group therapy. However, several of the Trauma Management Therapy Program’s participants have, in other interviews, stated that they found that aspect of the program to be especially helpful. Could you talk a little about how the group therapy sessions work and why there seems to be such a difference between the perception of group therapy among veterans and its actual success rate?

Avoidance and social withdraw are both primary symptoms of PTSD. Many veterans initially reject the idea of group therapy because they want to avoid talking about their military experiences and they don’t want to associate with others. However, our group program does not focus on the past – it uses a skills building approach to help veterans learn how to manage emotions and how to increase their socialization. As the PTSD symptoms are alleviated by the individual therapy, veterans tend to be more receptive to group. The group focuses on areas of PTSD that are not directly targeted by exposure therapy (such as social reintegration) and therefore is helpful for the veteran’s overall quality of life.

5) The Trauma Management Therapy Program is conducted in both 17-week and intensive 3-week cycles. When do the next cycles begin, are there slots available, and, if so, how would a veteran interested in the program go about applying for one of those slots?

Both programs involve 29 therapy sessions (15 individual and 14 group sessions). There are slots available in both programs. If you have served in Iraq or Afghanistan and think you may have combat-related PTSD, just call 407-823-1668 for a confidential phone interview.

The 17-week program is open-access. A veteran or active duty service member will receive an appointment within 48 hours of calling. A full assessment will be conducted to determine a diagnosis of PTSD as well as any other co-occurring disorders. The individual appointments for the 17 week program are scheduled directly with the therapist to accommodate participant’s schedules. When group begins, the therapists will coordinate schedules of the 4-6 members to determine the best time. This treatment is available for those who live close enough to UCF or Daytona Beach to commute for treatment. There is no cost for treatment.

The 3-week program is conducted once per month. The treatment begins on a Monday and is conducted each weekday, morning and afternoon, for three weeks. This treatment is typically for veterans and active duty personnel from outside the Orlando area but may be beneficial for other individuals for other reasons as well. Housing is included in the treatment at no cost. The initial assessment is conducted by phone to determine eligibility.

Note: The Trauma Management Treatment Program is open to all servicemembers and veterans who have served in OIF/OEF/OND, regardless branch of service or discharge status. If you would like to participate in or find out more about the program, you can do so here.

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