New resources to improve client resilience
Military service can presents challenges and risks. Being able to cope and bounce back from stress or potentially traumatic events is particularly relevant for individuals who have served in the Australian Defence Force (ADF).
While there are a number of mental health apps and websites in the marketplace, DVA’s new High Res suite of products are the only psychological resilience resources specifically designed for serving and ex-serving ADF members and their families.
The High Res website and companion mobile app were developed by DVA in collaboration with the Department of Defence, Phoenix Australia and the Young and Well Cooperative Research Centre. The products help users to manage the daily stresses of military life, deployment, transition to civilian life and life post-service. Families can also use High Res to help themselves as well as supporting their family members.
The High Res app for smartphones and tablet devices, offers CBT-based tools to help users manage their physical, cognitive, emotional and behavioural reactions to stress and adjust their response in real time. Users can also use the app to schedule practicing selected tools to build their psychological resilience and mental fitness over time.
The High Res website is designed for learning about building physical, behavioural, cognitive and emotional resilience with self-help resources and videos. It also features case studies about overcoming challenges during military training, deployment and adjusting to life post-service, as well as a personal goal setting plan where users can develop a resilience plan, set goals and track their progress.
The individual tools featured in the High Res app and website use can be used in conjunction with a structured treatment regime. They can be used by clients in their own time, but the exercises can also be conducted within a clinical setting, with results being discussed with the mental health treatment provider.
DVA Evidence Compass
DVA’s Evidence Compass website is a searchable tool providing access to research literature on military and veteran health and wellbeing. Equipped with an understanding of the nature and quality of literature offered on the Evidence Compass, you will be in the best position to make well-informed decisions that ensure that veterans and their families receive the support they need to lead healthy and productive lives.
The Evidence Compass allows research literature to be organised, reviewed, synthesised and disseminated in relation to questions of high importance to DVA and the veteran community. The Evidence Compass contains literature reviews that utilises three main methodologies, including systematic reviews, rapid evidence assessments, and narrative reviews. The choice of methodology depends on the type of question, the degree of certainty about the conclusions reached, the time available to conduct the review and cost. The latest questions to have a literature review undertaken by the DVA Evidence Compass include:
- What is the prevalence of risk-taking behaviours in the children of former or current military personnel?
- What are the family protective factors for members transitioning from Defence service
- What are effective interventions for veterans who have experienced moral injury?
- What are effective psychological or multi-modal interventions for adults experiencing chronic pain?
- Is stepped care an effective model for the delivery of treatment for depression and anxiety?
DVA is also interested in hearing from health professionals who provide mental health services and treatment to veterans and their families on ideas for new review questions that would help them in their practice.
The Evidence Compass is available at www.evidencecompass.dva.gov.au. If you would like further information about the Evidence Compass online tool, existing literature reviews, or suggestions for new review questions, please email: DVA.Research@dva.gov.au.
The Right Mix – A redesigned approach to your health and alcohol.
The Right Mix has been popular in delivering the message about maintaining a healthy balance of alcohol consumption, diet and exercise. The recent redesign of the website provides greater interactivity and a new self-help action plan using the clinical evidence base for ‘motivational enhancement’.
The new website also uses cognitive behavioural therapy (CBT) self-help strategies to promote behaviour change. Using the interactive tools, clients can quickly measure how much they drink, compare their drinking habits against low risk levels, and find out how much exercise is needed to burn off extra kilojoules from drinking. The website then enables clients to develop an action plan with goals tailored to their individual motivations. They can track their progress using data collected through the companion app ON TRACK with The Right Mix, which allows them to track their consumption on the go. The drinking data can then be viewed on the phone, uploaded to The Right Mix website or emailed to their treating clinician.
Clinicians can use The Right Mix website to complement a client’s treatment regime, and help their client to:
- Measure alcohol consumption, compare their usage against low risk levels and provide strategies to help reduce and manage consumption in the future;
- Recognise and align beliefs and expectations surrounding low risk drinking;
- Develop a CBT self-help action plan; and
- Commit to change their behaviour and motivate and empower them to achieve their set goals.
The website reflects the evidence base on the health effects of alcohol, including the increased risk of cancers, other health problems and the risk of injury from drinking above the recommended low-risk guidelines.
DVA will be at the Australian and New Zealand Addiction Conference on 18-20 May 2016, on the Gold Coast, presenting on how to use The Right Mix in treatment. See www.addictionaustralia.org.au.
A trial of faster treatment for PTSD
The National Health and Medical Research Council recently announced the success of a combined DVA, Defence and Phoenix Australia partnership project to conduct a randomised control trial of Intensive Prolonged Exposure Therapy for Posttraumatic Stress Disorder (PTSD).
PTSD continues to be the most commonly claimed mental health condition for DVA. It is a seriously disabling condition associated with high levels of distress, reduced quality of life, decreased occupational and social functioning, increased family dysfunction and high long-term healthcare costs in both veteran-specific and general health services. DVA and Defence are very interested in new treatment options for PTSD to improve veteran quality of life.
Prolonged Exposure is one of the most effective treatments we have for PTSD. In its current form it requires weekly treatment for 10 weeks. This poses significant barriers to access and uptake for serving and ex-serving ADF personnel. The Phoenix Australia team (through the University of Melbourne) will assess whether an intensive delivery of prolonged exposure therapy, which will involve 10 sessions over a 2 week period, will deliver outcomes which are comparable to standard prolonged exposure. Early evidence suggests that intensive exposure therapy is as effective as the standard approach but to date there have been no rigorous studies comparing the effectiveness of the two options in a real-world clinical setting.
The trial will commence in mid-2016, and involve 200 participants recruited through a referral process across three states – Queensland, New South Wales and Victoria. Pre-trial preparation is underway to secure treatment sites within defence and veteran service systems, identify the team of treating clinicians and set-up the processes for serving and ex-serving ADF personnel to participate in the trial.
If Intensive Prolonged Exposure therapy proves equivalent to the standard delivery of exposure therapy, it will address barriers to care and directly influence DVA and Defence policy and the delivery of evidence-based treatment by health providers nationwide. For veterans and military personnel with PTSD, providing a treatment option with reduced duration of therapy has the potential to increase uptake of evidence based treatment, reduce PTSD severity and deliver positive impacts on employment and relationships. There is also the potential that the evidence from this trial will not only inform the treatment of veteran and military personnel but could be applied to PTSD sufferers across the Australian community.