Residential Treatment for Combat Stress: A Comprehensive Approach
PURPOSE: Moncrief Army Community Hospital (MACH) identified critical shortcomings in programs where soldiers were receiving intensive psychiatric care. Medical co-morbidities were minimally addressed and Soldiers did not like having to “start over” upon completing intensive treatment. The Combat Stress and Addictions Recovery Program (CSARP) was created to fill these gaps. The CSARP model is innovative because it is the Army’s first residential treatment program for post deployment issues incorporating evidence based treatments that patients continue after discharge without having to start over with new providers. In a recent Joint Commission survey, the inspector cited the CSARP model as a lead practice.
EXPECTED OUTCOME OF IMPLEMENTATION: Soldiers will function at higher levels across multiple domains and will be better prepared for outpatient follow up. Success will be determined by comparing scores obtained upon admission and discharge from CSARP.
METHODS USED TO EVALUATE EFFECTIVENESS: Soldiers complete self-administered outcome measures upon admission and at discharge on multiple domains of functioning. Preliminary data on patients admitted since April 2011 demonstrate statistically significant findings on the PCL-M, t (30)=4.43, p=.000, the PTCI, t (45)=4.25, p =.000, and the BDI-II, t(43)=5.88, p =.000, indicating a significant decrease in reported symptoms of PTSD and depression.
IMPLICATIONS: The CSARP model offers a comprehensive approach to PTSD and medical co-morbidities, while maintaining treatment continuity. As CSARP patient outcomes continue to produce positive findings, the program should look to become a lead practice for residential treatment of PTSD.