2. When did you set the charity up?
The PTSD Resolution project has been running since January 2007. It has operated to date as a project inside another well-established mental health charity, the Human Givens Institute ( http://www.hgi.org.uk/ ). Resolution is incorporated as an independent charitable body with the UK Charity Commissioners. Registered Charity No. 1133188.
3. What exactly does the charity do?
Treatment involves one-to-one confidential sessions with a PTSD Resolution programme therapist on an out-patient basis. In the treatment, the objective is to break the link between the memory and emotional response, using the patient’s own innate mental resources. By reducing anxiety levels connected to the memories the patient is enabled to re-experience the traumatic event without further distress.
Resolution treatment is brief, so that there is no continuing reliance upon therapy. A course of treatment usually involves four sessions on average, each of around one hour’s duration. The goal is to enable each patient to return to as normal a family, social and work life as possible, in the shortest possible time. Progress is measured at the start of each session using the ‘Impact of Events Scale’, commonly used by trauma therapists in the NHS.
Resolution treatment is based upon well-established methods developed for Human Givens Therapy, a branch of psychology and psychotherapy which initially focused on the treatment of mental distress in the general population when established in 1997.
This year The British Psychological Society’s leading peer-reviewed journal, Psychology and Psychotherapy: Theory, Research and Practice published a 12-month evaluation of the Human Givens approach in primary care at a general medical practice showing that more than three out of four patients were either symptom-free or reliably changed as a result of HG therapy*. This was accomplished in an average of only 3.6 sessions, significantly better than the recovery rate published for the UK government’s flagship IAPT (Improving Access to Psychological Therapies) programme, which uses therapists trained in cognitive behavioural therapy (CBT).
* Andrews, W., Twigg, E., Minami, T. and Johnson, G. (11 February 2011) ‘Piloting a practice research network: A 12-month evaluation of the Human Givens approach in primary care at a general medical practice. Psychology and Psychotherapy: Theory, Research and Practice. doi:10.1111/j.2044-8341.2010.02004.
Resolution has access to a network of 200 therapists, trained by and registered with the Human Givens Institute, and specialises in helping only former services personnel and dependents.
Therapists in the PTSD Resolution programme use Trauma-Focused Cognitive Behavioural Therapy (CBT) which is a treatment for Post Traumatic Stress Disorder (PTSD) approved by the National Institute for Health and Clinical Excellence (NICE)
In addition to compliance with NICE guidelines, the PTSD Resolution treatment is designed to accommodate the special circumstances of veterans of the armed services. Treatment does not require the patient to talk about the events that may have caused the traumatic memory. Any referencing of the incidents during treatment that may be necessary is undertaken as sympathetically as possible, with the patient in a highly relaxed state, to avoid further distress.
The patient’s calm state during treatment, and the absence of any verbal recounting of the traumatic episode, ensure that the PTSD Resolution version of trauma-focused CBT is as compassionate and supportive as possible, as well as fully compliant with NICE guidelines.The treatment programme is sensitive to the particular cultural background and trauma issues associated with the armed services. The methods used do not require the therapist to have any knowledge of the particular traumatic event: this ensures confidentiality and protects both the patient and therapist from further trauma. Unlike some other treatment settings, Resolution therapists work with other conditions that may co-exist with PTSD - such as alcohol and drug use, depression, anger and relationship issues.
Treatment uses a combination of techniques: ‘deep relaxation’; ‘imaginal exposure’, where a patient is asked to imagine the feared situation; and ‘cognitive reconstruction’, to help the client reassess a rigidly-held position on the event that occurred. All of these are components of treatments recommended by the National Institute for Clinical Excellence (NICE).
4. Why was it set up?
Resolution was set up to make therapy available more easily to veterans who need it. Waiting times in the NHS and other treatment services can be 18 months or even indefinite, and some areas have no trauma specialists in post.
A distinctive quality of PTSD Resolution's approach is that therapy is as 'humane' as possible. In most NHS settings veterans would be expected to recount their traumatic experiences in detail, but this is not generally necessary to deal effectively with the symptoms and there are kinder ways to treat trauma, including non-verbal re-exposure methods.
These are taught in the UK but are too specialised to be available across the NHS. Resolution uses a visual imaginal exposure method to change the emotional impact of traumatic memories, within a programme that also includes relaxation training, psycho-education and cognitive restructuring.
This deals effectively in most cases with the immediate symptoms of PTSD, such as flashbacks and nightmares, that otherwise inhibit progress in treating other problems such as addiction and addressing homelessness, for example.
5. What makes the charity different?
PTSD Resolution was set up to offer treatment that offered advantages in speed, cost, convenience, privacy and effectiveness over other generally available programmes.
Resolution is complementary to treatment and support offered by other forces' charities and can assist a return to normal work and family life.
Resolution offers the option for out-patient treatment which will usually enable the patient to be symptom-free in a very short period of time. A course is often available close to where patients live, through a large network of therapists around the UK, rather than requiring residential care, perhaps far from the patient’s home.
There are no lengthy procedures to assess entitlement to help, such as through referrals, service record, or medical history - as the case of most alternative programmes in the sector. All ex-service people are eligible for treatment by a qualified therapist through PTSD Resolution, free of charge.