Treating Posttraumatic Stress Disorder in Combat Veterans: A Guide to Using Behavior Therapy for Anxiety and PTSD (BTAP)

Abstract

PTSD is a chronic and disabling condition associated with psychiatric and medical comorbidity and diminished quality of life. Military Veterans are at increased risk for developing PTSD, and combat-related PTSD may be more difficult to treat than civilian PTSD. Both Prolonged Exposure and Cognitive Processing Therapy are empirically supported treatments for PTSD in military populations with a strong empirical foundation. However, they require considerable resources to implement and can be difficult for providers and patients to learn. To address these limitations, we created Behavioral Therapy for Anxiety and PTSD (BTAP), which is a simple, behavior-based therapy rooted in learning theory. Building on empirically established therapies such as Prolonged Exposure, BTAP has a singular focus on identifying, reducing, and countering safety behaviors that maintain PTSD. Because it only focuses on safety behaviors, it is simple to learn and implement; therapist trainings are one day, and follow-up consultation provided as needed. In this special issue article, we describe the BTAP protocol as well as provide real world case examples from Veterans to illustrate key components of the treatment. We also present data from five Veteran patients that demonstrate feasibility, acceptance, and preliminary evidence of effectiveness. Patients reported significant reductions in PTSD symptoms, depressive symptoms, intrusions, and safety behaviors. This work suggests that BTAP for treating PTSD merits further investigation.