Skype therapy? It's working for veterans

July 5, 2013 by Tony Perry

Ruben Moreno Garcia, who served three combat tours in Iraq, now lives with his family in this Imperial Valley community and works as a mechanic in Yuma, Ariz.

Kathryn Williams, a for the Department of Veterans Affairs, has an office in the San Diego neighborhood of La Jolla, more than a hundred miles away.

Williams and Moreno Garcia meet once a week for an hour or so to discuss his progress in coping with post-traumatic stress disorder, the condition common to U.S. military personnel who served in Iraq and Afghanistan.

Their sessions are over the Internet, using a firewall-protected connection and a different password for each session.

"Being in your own living room for sessions, that's comfortable," said Moreno Garcia, 31, who studied computers before enlisting in the Army.

Williams concedes she was somewhat suspect of the therapy-by-Internet method.

"I've been doing therapy face-to-face for 10 years, so I was skeptical," Williams said. "But after one or two sessions, you forget about the camera."

Dr. Nilesh Shah, director of telemedicine for the VA San Diego, is blunt about his assessment of the method, particularly in helping the growing number of VA patients that need long-term management for conditions such as PTSD, diabetes or obesity.

"It's the future," he said.

In the past nine months, 240 veterans served by the VA San Diego have had nearly 900 therapy sessions for PTSD using videoconferencing.

In most cases, the patient came to a VA clinic where the technology was already in place to meet with a therapist located elsewhere. For a few patients, such as Moreno Garcia, sessions were done in their homes using Cisco Jabber or Skype.

The veterans are spread throughout California. The program is being extended to veterans in Nevada, Oregon and Alaska.

Initial studies about the effectiveness of the videoconferencing approach have been positive, according to Steven Thorp, a clinical psychologist for the VA San Diego. He was the lead researcher in a recent study of 207 veterans enrolled in a 12-week course of PTSD therapy.

Veterans receiving the traditional approach to therapy - patient and therapist in the same room - showed progress more quickly in dealing with hyper-vigilance, mood swings and other aspects of PTSD.

But in the longer-term, videoconferencing patients progressed at a rate such that at the end of the 12 weeks, there was no difference between the two groups, according to the study published last year in Psychological Services, a journal of the American Psychological Association.

"The face-to-face method is never going away - it's been around a long time," Thorp said. "But this is only going to get bigger."

There are occasional technical problems in using the Internet for live transmission: pixelation, choppiness and freezing. In one case, a therapist did not notice for three sessions that the patient was in a wheelchair, according to the study.

A decrease in empathy is also a possibility. "Physical contact, like shaking hands and handing tissues to a sobbing client, is not possible" with , the study noted.

Still, the approach is seen as a boon for who do not live near a VA hospital or clinic. There is a VA clinic in El Centro, but Moreno Garcia, who makes a 100-mile round trip each day to his job as a mechanic with the Border Patrol in Yuma, decided that making appointments was dicey.

Born in Mexicali, Mexico, Moreno Garcia spent six years on active duty in the Army, during which he became a U.S. citizen.

Assigned to an engineer company, Moreno Garcia spent much of his time in Iraq "outside the wire," responding to situations where U.S. vehicles had been attacked by roadside bombs. "They couldn't get anyone out until I arrived," he said.

Promoted to sergeant, he lost a stripe when he punched a superior who Moreno Garcia said was disrespecting his comrades. His marriage fell apart and he began to drink. Two of his high school friends were killed in Iraq.

Tears came to Thelma Moreno's eyes when she remembered how her son looked and acted when he returned home three years ago.

"I had prayed to God and the Virgin Mary to bring him back to us," she said. "But he was so different, so unhappy. I would tell him, 'Ruben, relax, you're not there anymore, you're safe, here with the family.' "

Finally, she said, her son decided to seek help.

For two years, Moreno Garcia has been working with Williams, although the two have never been in the same room.

"You can go whole weeks, and then something happens and your brain is back in the war, with the hyper-vigilance and fight-or-flight," Moreno Garcia said. "You need help managing moods and feelings. That's where Dr. Williams helps."

His mother is happy with the progress he's shown: being better able to concentrate and maintain a positive outlook on life. "We have our son back," she said.

But she worries about other soldiers who are not yet receiving help. "Any soldier who comes home from war needs our support," she said.

Explore further: For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests

Related Stories

For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests

May 18, 2013
Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...

'One-stop' clinic ups mental health, social work visits for veterans

June 10, 2011
Iraq and Afghanistan veterans who visited a VA integrated care clinic were much more likely to undergo initial mental health and social work evaluations than veterans who visited a standard VA primary care clinic, according ...

Improve care for veterans with PTSD: report

July 13, 2012
(HealthDay) -- Access to care for U.S. military service members and veterans with post-traumatic stress disorder (PTSD) must improve, says an Institute of Medicine report released Friday that also calls for better tracking ...

Substance-use disorders linked to increased risk of death for veterans with PTSD

September 18, 2012
Veterans suffering from post-traumatic stress disorder who are also battling drug or alcohol problems face a higher risk of death, according to new research from the University of Michigan Health System and the VA Ann Arbor ...

Mindfulness therapy might help veterans with combat-related post-traumatic stress disorder

April 17, 2013
Mindfulness exercises that include meditation, stretching, and acceptance of thoughts and emotions might help veterans with combat-related post-traumatic stress disorder find relief from their symptoms.

Recommended for you

Short-course treatment for combat-related PTSD offers expedited path to recovery

January 23, 2018
Symptoms of Post-Traumatic Stress Disorder (PTSD) can be debilitating and standard treatment can take months, often leaving those affected unable to work or care for their families. But, a new study demonstrated that many ...

Priming can negate stressful aspects of negative sporting environments, study finds

January 23, 2018
The scene is ubiquitous in sports: A coach yells at players, creating an environment where winning is the sole focus and mistakes are punished. New research from the University of Kansas shows that when participants find ...

Social and emotional skills linked to better student learning

January 23, 2018
Students with well-developed and adaptive social and emotional behaviours are most likely to excel in school, according to UNSW researchers in educational psychology.

Study of learning and memory problems in OCD helps young people unlock potential at school

January 22, 2018
Adolescents with obsessive-compulsive disorder (OCD) have widespread learning and memory problems, according to research published today. The findings have already been used to assist adolescents with OCD obtain the help ...

People with prosthetic arms less affected by common illusion

January 22, 2018
People with prosthetic arms or hands do not experience the "size-weight illusion" as strongly as other people, new research shows.

Intensive behavior therapy no better than conventional support in treating teenagers with antisocial behavior

January 19, 2018
Research led by UCL has found that intensive and costly multisystemic therapy is no better than conventional therapy in treating teenagers with moderate to severe antisocial behaviour.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.