Post Traumatic Stress Disorder (PTSD)

The PTSD rotation will provide interns with experience assessing and treating PTSD in a veteran population. Emphasis is placed on evidence-based assessment and treatment practices. Interns will learn to identify and treat PTSD and other trauma-related sequelae (e.g., guilt, grief, depression). The veteran population in Iowa City includes individuals with acute and chronic trauma-related symptoms related to combat trauma and sexual trauma, as well as civilian trauma, such as childhood abuse histories, accidents, or domestic violence.

PTSD Assessment: Interns will conduct initial diagnostic interviews with veterans who have both acute and chronic trauma-related symptoms. The training goal is to help interns recognize PTSD, make reliable differential diagnoses between PTSD and similar disorders, as well as to identify and address comorbid diagnoses. Interns will use structured interview and standardized self-report measures to improve their diagnostic skills. Some complex cases may require MMPI-2 assessment and/or referral to neuropsychology and review of that data.

PTSD Treatment: Interns will have to opportunity to learn and use several evidence-based PTSD treatments, including Cognitive Processing Therapy (e.g., Resick & Schnicke, 1993; Monson et al., 2006), Prolonged Exposure Therapy (e.g., Foa, Hembree, & Rothbaum, 2007), and Seeking Safety (Najavits, 2002). Our most exciting addition, however, is Virtual Reality Therapy for PTSD. The Iowa City VAMC is one of only a few VAMCs to have this state-of-the-art option. Interns will have the opportunity to learn how to use this technology in treating PTSD.

In addition to individual therapy, the PTSD rotation provides group therapy experiences. Interns may co-facilitate the Cognitive Processing Therapy group treatment, Anger Management Group, or a Sleep Disorders Psychoeducation Group. These experiences will allow interns to learn or build their fundamental group skills, while implementing structured treatment protocols. Interns may have the opportunity to observe or participate in on-going support groups for veterans.

Supervision and Training: Heather Cochran, Ph.D. will serve as the primary supervisor of the PTSD rotation. Her supervision methods will be tailored to the intern's needs, and may include co-therapy, co-facilitating groups, audio recording and review of sessions, and discussion of clinical and professional issues. Additionally, the clinic includes several other highly skilled clinicians with varying areas of specialization who are available for consultation. Interns will attend the monthly PTSD Clinical Team Case Conference and have the opportunity to participate in telephone conferences on clinical issues, such as cognitive processing therapy or sexual trauma.

And Much More!: This summary represents some of the core PTSD rotation experiences. However, there are others, including consultation to psychiatry residents, PTSD Orientation Class for veterans, outreach events, and telemedicine therapy. With so many choices, Dr. Cochran will be happy to guide interns in planning their training experience so that they benefit from both the breadth and depth of possibilities on this rotation.