This article summarizes the revised Department of Veterans Affairs/Department of Defense Clinical Practice Guideline (CPG) for the management of posttraumatic stress and the prevention of posttraumatic stress disorder. The revised CPG includes screening and early interventions for early stress states, like acute stress reaction, combat operational stress reaction, and acute stress disorder. The article aims to help providers work with veterans in a way that is consistent with the CPG–s evidence-based or evidence-informed recommendations. For instance, the CPG advises that treatments in the first 4 days after a potentially traumatic event should focus on safety; basic needs; and physical, emotional, and social resources. Further medical and psychiatric assessment and brief, trauma-focused cognitive- behavioral therapy are necessary if the veteran–s distress or inability to function continues or gets worse after 2 days or becomes an acute stress disorder. Medicine and self-calming techniques are recommended for symptoms like insomnia and hyperarousal. Follow-up monitoring and rescreening are recommended for at least 6 months. Four successful Federal programs illustrating these principles are also described.
Volume 49 Number 5, 2012
Pages 637 — 648
Last Reviewed or Updated Wednesday, July 18, 2012 9:09 AM