Military Review English Edition November December 2016 | Page 96

Behavioral therapy programs for soldiers with PTSD
range from individualized therapy to group fly-fishing
trips.15 Among veterans, 20–50 percent discontinue
behavior therapy before the treatment is complete.16
Accordingly, doctors develop and use treatments that
include activities one would naturally do, such as video
games and outdoor activities, which are more likely to be
continued after the official treatment.17
The most effective pharmacological approach is use
of selective serotonin reuptake inhibitors (SSRIs). These
SSRIs elevate brain levels of serotonin, a neurotransmitter that regulates pain suppression and mood.18
However, various side effects—including agitation,
nausea, diarrhea, and low sex drive—often lead to poor
compliance.19 Moreover, for those with PTSD who are
compliant, these medications have only a 60 percent response, with “only 20–30 percent of patients [achieving]
complete remission.”20 There are other pharmacological
options, but they have even lower effectiveness or worse
side effects, so SSRIs are seen as the best overall pharmacological treatment for PTSD.21
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A soldier stands with two warrior-trained therapy dogs 7 November
2011 at the Warrior Canine Connection Healing Quarters in Brookeville, Maryland. (Photo courtesy of Warrior Canine Connection)

One reason for soldiers not following through on
both psychological and pharmacological approaches is
the perceived stigma of the diagnosis and the associated treatment.22 This stigma results from fear of being
perceived as weak, belief that superiors look down upon
treatment, and fear of potential repercussions for seeking
help.23 Such attitudes toward mental health treatment
vary by gender and marital status, but are widely held.24
Certain types of treatment have also been shown to have
a higher stigma than others. For instance, service members would rather have behavioral “exposure” therapy
than medication therapy.25

Using Dogs to Treat PTSD
There is evidence that using therapy dogs in treatment of PTSD can result in much-improved outcomes,
such as a servicemember previously assessed as likely to
November-December 2016  MILITARY REVIEW