Formation | 12 May 1919 |
---|---|
Type | Charitable organisation |
Registration no. | England and Wales: 206002 (as Ex-Services Mental Welfare Society) [1] |
Focus | Treating post traumatic stress disorder (PTSD), and other mental health issues |
Location |
|
Area served | United Kingdom |
Key people | Charles, Prince of Wales (Patron) General Sir Peter Wall (President) |
Affiliations | Member of COBSEO |
Revenue | £14.96 million (2015) [1] |
Employees | 285 (2015) [1] |
Volunteers | 55 (2015) [1] |
Website | https://www.CombatStress.org.uk/ |
Formerly called | Ex-Services Mental Welfare Society Ex-Servicemen's Welfare Society |
Combat Stress is a registered charity in the United Kingdom offering therapeutic and clinical community and residential treatment to former members of the British Armed Forces who are suffering from a range of mental health conditions; including post traumatic stress disorder (PTSD). [1] [2] [3] Combat Stress makes available treatment for all Veterans who are suffering with mental illness free of charge.
On average, it takes 13 years for a Veteran to first contact with Combat Stress for advice, help, and treatment; however for those who served in Iraq (Gulf War I and Gulf War II) and Afghanistan, the time period is much lower.
The charity was formed in 1919, as the Ex-Servicemen's Welfare Society, following World War I; when the effects of shell shock were becoming known. [4]
Soldiers (and other frontline personnel) returning home from World War I suffered greatly from the horrors of war that they had witnessed. Many returning veterans suffered from what was then known as shell shock; now known as post traumatic stress disorder (PTSD).
In 1915, the British Army in France was instructed that:
Shell-shock and shell concussion cases should have the letter 'W' prefixed to the report of the casualty, if it were due to the enemy; in that case the patient would be entitled to rank as 'wounded' and to wear on his arm a 'wound stripe'. If, however, the man’s breakdown did not follow a shell explosion, it was not thought to be ‘due to the enemy’, and he was to [be] labelled 'shell-shock' or 'S' (for sickness) and was not entitled to a wound stripe or a pension. [5]
In August 1916, Charles Myers was made Consulting Psychologist to the Army. He hammered home the notion that it was necessary to create special centres near the line using treatment based on:
He also used hypnosis with limited success.[ citation needed ]
In December 1916, Gordon Holmes was put in charge of the northern, and more important, part of the western front. He had much more of the tough attitudes of the Army, and suited the prevailing military mindset, and so his view prevailed. By June 1917, all British cases of 'shell-shock' were evacuated to a nearby neurological centre, and were labelled as NYDN – 'not yet diagnosed nervous'. "But, because of the Adjutant-General's distrust of doctors, no patient could receive that specialist attention until Form AF 3436 had been sent off to the man’s unit and filled in by his commanding officer." [5] This created significant delays, but demonstrated that between 4-10% of shell-shock W cases were 'commotional' (due to physical causes), and the rest were 'emotional'. This killed off shell-shock as a valid disease, and it was abolished in September 1918.[ citation needed ]
During the war, 306 British soldiers were executed for cowardice; many of whom were victims of shell shock. [6] On 7 November 2006, the Government of the United Kingdom gave them all a posthumous conditional pardon. The Shot at Dawn Memorial at the National Memorial Arboretum in Staffordshire commemorates these men. [7]
Combat Stress was formed at a time when there was little known about mental health problems affecting ex-Service men and women who had returned home after serving in war and conflict zones.
Currently, the organisation is helping almost 6,000 people who are Veterans aged from 19 to 97. [8] Combat Stress are currently treating 971 Veterans who served in Afghanistan and 1,185 who served in Iraq.
Support is currently being given to those who suffer from:
This support is delivered throughout England, Scotland, Wales, and Northern Ireland; through three treatment centres (Hollybush House, Ayr, Ayrshire, Scotland; Audley Court, Newport, Shropshire, England and Tyrwhitt House, Leatherhead, Surrey, England). Hollybush House and Tyrwhitt House offer residential support and Audley Court operates as an outpatient base along with community outreach teams.
Services are provided by qualified professionals which include psychotherapists, Occupational Therapists,Nurses and Art Therapists
Leatherhead and Ayr offer a residential treatment service and Newport offers only outpatient treatment from 09.00 until 04.30 Monday to Friday.
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.
A veteran is a person who has significant experience and expertise in an occupation or field.
Direct therapeutic exposure (DTE) is a behavior therapy technique pioneered by Patrick A. Boudewyns, where stressors are vividly and safely confronted to help combat veterans, and patients with posttraumatic stress disorder (PTSD), panic disorder, or phobias. Exposure therapy has supporting evidence with both simple and complex traumas. A similar therapy is Eye Movement Desensitization and Reprocessing (EMDR). First known publication in book form is Flooding and Implosive Therapy: Direct Therapeutic Exposure in Clinical Practice by Patrick A. Boudewyns, Robert H. Shipley. 1983. ISBN 0-306-41155-5.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples include violence, rape, or a terrorist attack.
Combat stress reaction (CSR) is acute behavioral disorganization as a direct result of the trauma of war. Also known as "combat fatigue", "battle fatigue", or "battle neurosis", it has some overlap with the diagnosis of acute stress reaction used in civilian psychiatry. It is historically linked to shell shock and can sometimes precurse post-traumatic stress disorder.
Acute stress reaction and acute stress disorder (ASD) is a psychological response to a terrifying, traumatic or surprising experience. Combat stress reaction (CSR) is a similar response to the trauma of war. The reactions may include but are not limited to intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. It may be exhibited for days or weeks after the traumatic event. If the condition is not correctly addressed, it may develop into post-traumatic stress disorder (PTSD).
Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
Animal-assisted therapy (AAT) is an alternative or complementary type of therapy that includes the use of animals in a treatment. The goal of this animal-assisted intervention is to improve a patient's social, emotional, or cognitive functioning. Studies have documented some positive effects of the therapy on subjective self-rating scales and on objective physiological measures such as blood pressure and hormone levels.
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.
Shell shock is a term that originated during World War I to describe the type of post-traumatic stress disorder (PTSD) that many soldiers experienced during the war, before PTSD was officially recognized. It is a reaction to the intensity of the bombardment and fighting that produced helplessness, which could manifest as panic, fear, flight, or an inability to reason, sleep, walk, or talk.
Vets Prevail, is a veteran-created online mental health program developed and supported by Prevail Health Solutions. It was created to combat the challenges faced by returning OEF and OIF veterans suffering from depression and post-traumatic stress disorder (PTSD). The program combines the principles of Cognitive Behavioral Therapy (CBT) with interactive e-learning techniques to educate and provide veterans with tools to overcome mental health challenges faced upon returning home from deployment. Vets Prevail utilizes a variety of techniques including: interactive videos, live chats with trained Peer Coaches, and a peer network of veterans to motivate and help veterans readjust to life after returning home.
Cognitive processing therapy (CPT) is a manualized therapy used by clinicians to help people recover from posttraumatic stress disorder (PTSD) and related conditions. It includes elements of cognitive behavioral therapy (CBT) treatments, one of the most widely used evidence-based therapies. A typical 12-session run of CPT has proven effective in treating PTSD across a variety of populations, including combat veterans, sexual assault victims, and refugees. CPT can be provided in individual and group treatment formats and is considered one of the most effective treatments for PTSD.
PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.
Perpetrator trauma, also known as perpetration- or participation-induced traumatic stress , both abbreviated to PITS, occurs when the symptoms of posttraumatic stress disorder (PTSD) are caused by an act or acts of killing or similar horrific violence.
Trauma focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy or counselling that aims at addressing the needs of children and adolescents with post traumatic stress disorder (PTSD) and other difficulties related to traumatic life events. This treatment was developed and proposed by Drs. Anthony Mannarino, Judith Cohen, and Esther Deblinger in 2006. The goal of TF-CBT is to provide psychoeducation to both the child and non-offending caregivers, then help them identify, cope, and re-regulate maladaptive emotions, thoughts, and behaviors. Research has shown TF-CBT to be effective in treating childhood PTSD and with children who have experienced or witnessed traumatic events, including but not limited to physical or sexual victimization, child maltreatment, domestic violence, community violence, accidents, natural disasters, and war. More recently, TF-CBT has been applied to and found effective in treating complex posttraumatic stress disorder.
Richard Allan Bryant is an Australian medical scientist. He is Scientia Professor of Psychology at the University of New South Wales (UNSW) and director of the UNSW Traumatic Stress Clinic, based at UNSW and Westmead Institute for Medical Research. His main areas of research are posttraumatic stress disorder (PTSD) and prolonged grief disorder. On 13 June 2016 he was appointed a Companion of the Order of Australia (AC), for eminent service to medical research in the field of psychotraumatology, as a psychologist and author, to the study of Indigenous mental health, as an advisor to a range of government and international organisations, and to professional societies.
Operational stress injury or OSI is a non-clinical, non-medical term referring to a persistent psychological difficulty caused by traumatic experiences or prolonged high stress or fatigue during service as a military member or first responder. The term does not replace any individual diagnoses or disorders, but rather describes a category of mental health concerns linked to the particular challenges that these military members or first responders encounter in their service. There is not yet a single fixed definition. The term was first conceptualized within the Canadian Armed Forces to help foster understanding of the broader mental health challenges faced by military members who have been impacted by traumatic experiences and who face difficulty as a result. OSI encompasses a number of the diagnoses found in the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification system, with the common thread being a linkage to the operational experiences of the afflicted. The term has gained traction outside of the military community as an appropriate way to describe similar challenges suffered by those whose work regularly exposes them to trauma, particularly front line emergency first responders such as but not limited to police, firefighters, paramedics, correctional officers, and emergency dispatchers. The term, at present mostly used within Canada, is increasingly significant in the development of legislation, policy, treatments and benefits in the military and first responder communities.
WWII lasted from September 1st, 1939 until September 2nd, 1945. The death toll during WWII has been estimated to be between 35,000,000 and 60,000,000. However, the exact number is unknown. With all those fatalities, it should not be surprising that it left so many lasting effects on the survivors. There have been many terms for these lasting effects over the decades. These terms include, but are not limited to, shell sock and combat fatigue. In 1980, the diagnosis of PTSD was added to the newly published DSM 3.
Internet-based treatments for trauma survivors is a growing class of online treatments that allow for an individual who has experienced trauma to seek and receive treatment without needing to attend psychotherapy in person. The progressive movement to online resources and the need for more accessible mental health services has given rise to the creation of online-based interventions aimed to help those who have experienced traumatic events. Cognitive behavioral therapy (CBT) has shown to be particularly effective in the treatment of trauma-related disorders and adapting CBT to an online format has been shown to be as effective as in-person CBT in the treatment of trauma. Due to its positive outcomes, CBT-based internet treatment options for trauma survivors has been an expanding field in both research and clinical settings.
Being exposed to traumatic events such as war, violence, disasters, loss, injury or illness can cause trauma. Additionally, the most common diagnostic instruments such as the ICD-11 and the DSM-5 expand on this definition of trauma to include perceived threat to death, injury, or sexual violence to self or a loved one. Even after the situation has passed, the experience can bring up a sense of vulnerability, hopelessness, anger and fear.