U.S. Army Medical Department, Landstuhl Regional Medical Center
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Evolution Program


Location:
Bldg. 3758, Ward 2C

DSN Phone:
DSN 590-6302

CIV Phone:
06371-9464-6302

Hours:
Mondays through Fridays:
7:30 a.m. - 4:30 p.m.

Contact us 24/7 at usarmy.lrmc.evolution@mail.mil

Post-Traumatic Stress Disorder Intensive Outpatient Program

Mission:
The Evolution Intensive Outpatient Treatment Program (IOP) for Post-Traumatic Stress (PTS) at Landstuhl Regional Medical Center (LRMC) is an evidence-based, eight-week therapeutic program designed to help Servicemembers in all branches deal with the lasting effects of traumatic events.

Evolution offers two tracks: one for combat and deployment-related trauma; and one for sexual trauma from any time of life—not just military sexual trauma.

Evolution treats Servicemembers assigned to EUCOM, AFRICOM, and CENTCOM.

What is Post-Traumatic Stress?
PTS is the aftermath of exposure to traumatic events, experiences and situations. These traumas can be things you have experienced yourself, events you have witnessed, or incidents that violate your moral code or that represent a deep betrayal of trust.

PTS is characterized by:
- Re-experiencing (intrusive memories and images, nightmares, flashbacks, strong reactivity to reminders of the trauma)
- Hyperarousal (irritable, hypervigilant, on edge, trouble sleeping, jumpy)
- Avoidance (trying to avoid thinking or talking about events, avoiding places and activities, isolation, self-medicating with alcohol)
- Negative thoughts and emotional states (often feeling anxiety, horror, guilt, shame; self-blame; negative beliefs about self and others; feeling detached from others; unable to feel love or happiness)

Program Description:
Treatment is provided in group and individual therapy sessions. Each Servicemember receives about 25 hours of face-to-face treatment per week, and also does homework. Treatment is provided by multiple clinical disciplines. The primary evidence-based treatment model used in the program is Cognitive Processing Therapy (CPT). Other types of evidence-based treatment are used on a case-by-case basis, including Prolonged Exposure and Eye Movement Desensitization and Reprocessing (EMDR).

One aspect of treatment involves learning to challenge beliefs that cause anxiety, painful emotions, self-doubt and avoidance. Another piece of the program helps strengthen basic coping skills, such as learning how to reduce the fight-flight response (severe anxiety and hypervigilance) using a variety of relaxation techniques, yoga, and meditation. Yet another part of the program works on reducing nightmares and insomnia.

Evolution treats the full spectrum of symptoms associated with PTS—as described above—and also develops skills for dealing with grief and loss, relationship issues, communication, and the struggle many have with their own sense of self. In addition, consultation regarding medications used to treat PTS and other behavioral health problems is available.

The program, which began in March 2009, is designed from research into the effects of traumatic experience and mirrors successful programs at the former Walter Reed Army Medical Center and the Department of Veterans Affairs, as well as various programs run by psychologists in the U.S. Evolution is a joint military and civilian effort.

Treatment Components:
Individual Therapy
Addictive Behaviors
Anxiety Management (Relaxation Training)
Behavioral Desensitization
Cognitive Processing Therapy-Didactic
Cognitive Processing Therapy-Practice
Coping Skills
Emotion-Focused
Exposure Prep
Grief and Loss-Didactic
Grief and Loss-Process
Interpersonal Dynamics
Interpersonal Insight
Mindfulness Techniques (Yoga)
Positive Trait Building
Process Group
PTSD Prompted Discussion
Relationship Enrichment
Self-Awareness
Self-Esteem
Skill Building
Social Communication-Didactic
Social Communication-Practice
Spirituality
Prolonged Exposure Therapy (in individual sessions on a case-by-case basis)
Eye Movement Desensitization and Reprocessing (in individual sessions on a case-by-case basis)

Results:
There is no simple, quick fix for PTS. The problems usually have been present for a number of years before someone enters treatment, and changing habitual patterns is difficult. Despite these hurdles, Evolution has seen good results with a large number of patients, who have reported a significant decrease in the distressing symptoms of post-traumatic stress. We have seen family relationships improve, patients re-engage with the world around them, and improved ability to handle the triggers that have been so troublesome. Additionally, overall anxiety and depression symptom measures have decreased for many participants by the end of treatment.

Summary:
The Post Traumatic Stress Intensive Outpatient Program is the only program of its kind in the European theater, and is designed to successfully return Servicemembers with PTS symptoms to their units. The curriculum is an eight-week, therapeutically intensive program for Servicemembers who need more intensive treatment than routine outpatient behavioral health services in order to return to a functional state.

Contact us 24/7 at usarmy.lrmc.evolution@mail.mil