Innovations in The Treatment of Post-traumatic Stress Disorder
Professor Barbara Rothbaum, Emory Healthcare Veterans Program
The pharmacotherapy and psychotherapy literatures for post-traumatic stress disorder (PTSD) will be succinctly reviewed and discussed, focusing on cognitive behavioral treatments (CBT) and specifically exposure therapies. Innovations in the treatment of PTSD will be broadly divided into 1) Medium of Delivery of Exposure Therapy; 2) Enhancing Exposure Therapy with Pharmacological Agents; 3) Timing of Exposure Therapy, and 4) Treatment Delivery Schedules. The medium of delivery of exposure therapy will focus on Virtual Reality Exposure Therapy (VRE). Some of the pharmacological enhancing agents will include cognitive enhancers such as D-Cycloserine and psychedelics such as 3,4-methylenedioxymethamphetamine (MDMA). The timing of exposure therapy will discuss early interventions administered within hours of trauma exposure. Finally, massed prolonged exposure (PE) treatment delivery will be presented using the example of the Emory Healthcare Veterans Program intensive outpatient treatment model and pilot data will be presented.
How to sleep well – understanding the causes and cures for a bad night after trauma
Dr Kirstie Anderson, Newcastle-upon-Tyne Hospitals NHS Foundation Trust
Better nights for better days? Normal quantity and timing of sleep is vital for normal brain function. If sleep is interrupted for any reason it affects mood, memory and metabolism. Therefore improving sleep after a physical or mental health problem should be thought of as a key tool for recovery. The talk will cover the different causes of sleep disturbance after trauma and the evidence for effective therapies. Our research and sleep clinic work focuses upon the impact of sleep upon mental health and the benefits and sometimes side effects of the therapies and in particular medications used during and after major trauma. Education of health professionals, patient and families about sleep and sleep disorders is needed for health after injury.
Improving lives for people following traumatic brain injury
Professor Melinda Fitzgerald, Curtin University and the Perron Institute for Neurological and Translational Science
Traumatic brain injury (TBI) arises as a result of a physical injury to the brain and dramatically impacts the lives of both the patient involved and the people around them. There is a desperate need for new options to improve lives following TBI and give patients and their families hope for the future. TBI arises from a range of circumstances, such as concussion from playing sport, an elderly person having a fall or severe injury arising following a road accident. The resulting injuries vary in severity, ranging from mild to moderate or severe trauma to the brain. Symptoms also span a spectrum of severity, such as deficits in cognition through to vegetative states, varying degrees of lack of emotional control, poor mental health, disrupted balance and sleep disturbances. These can lead to dramatic, often long-lasting, impacts on patients and their families and a substantial financial drain on society.
The Australian Mission for TBI is a large scale federally funded initiative in Australia, providing 10 million AUD over 10 years. The Expert Advisory Panel for the Mission will define priorities for research funding that will improve outcomes for people following TBI of all severity, from concussion through to severe injuries. It is likely that the approach will include a large scale research registry that will enable the prediction of outcomes following injury. In addition, nationwide clinical trials of promising treatments will be conducted. The research of the Australian Mission for TBI has the potential to be transformative and lead to substantially improved outcomes for people who have experienced a TBI.
Using Virtual Reality (VR) to deliver engaging, efficacious, and fast psychological intervention
Professor Daniel Freeman, University of Oxford, UK
Mental health disorders are very common, but far too few people receive the best treatments. Much greater access to the best psychological treatments may be achieved using automated delivery in virtual reality (VR). With virtual reality simulations, individuals can repeatedly experience problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties. A key advantage of VR is that individuals know that a computer environment is not real but their minds and bodies behave as if it is real; hence, people will much more easily face difficult situations in VR than in real life and be able to try out new therapeutic strategies. VR treatments can also be made much more engaging and appealing for patients than traditional therapies. A systematic programme of work developing and testing automated VR psychological treatments will be described, with a particular focus on the gameChange (www.gameChangeVR.com) project for schizophrenia.
Major General (Rtd) Nick Caplin, Blind Veterans UK