Securing the foundation to overcome PTSD
Few mental health conditions rival the impact of post-traumatic stress disorder (PTSD). One of the most disabling and costly conditions in Canada, it's also among the most common – nearly 10 per cent of Canadians will develop PTSD during their lives, according to recent research.*
Unfortunately, access to effective, evidence-based treatment is out of reach for the vast majority of people with PTSD. The treatment may be unaffordable or unavailable in their area, or they may worry about the stigma associated with seeking help.
Improving access to treatment is at the crux of Candice Monson's latest research. A Ryerson University psychology professor and internationally recognized expert on PTSD, she recently won a prestigious research grant to expand her research program to help individuals with PTSD.
Monson will receive $1.7 million over seven years through the Foundation Grant program of the Canadian Institutes of Health Research. She is the first Ryerson University researcher to secure a Foundation Grant.
Rather than supporting a specific project, the Foundation Grant enables seasoned scholars to pursue new lines of research, wherever they may lead. That flexibility is crucial, says Monson.
"Sometimes your findings are unexpected and you want to explore them further," she says. "This grant will enable me to pursue a vision of expanding the reach of PTSD treatments for the many that need them."
Research has shown that the people in close relationships with those who have PTSD can be affected by PTSD. In response, Monson developed a successful form of face-to-face couple therapy that helps partners overcome PTSD and mend their relationship.
Over the past year, with funding from the Department of National Defence, she adapted her therapy program for use online. Couples complete web-based modules and assignments with some coaching from trained graduate students via phone calls and secure messaging. Going forward, Monson, with the support from her Foundation Grant, will further develop and test this e-health intervention, which is less costly than traditional therapy and which can be more accessible to people with mobility issues or who live in remote areas.
Monson will also test an individual therapy she co-developed, Cognitive Processing Therapy, to include and uniquely support individuals with PTSD and borderline personality disorder – some of the most impaired and highest users of health care.
Although PTSD treatment may reduce their symptoms of both conditions, these individuals are currently excluded from treatment research due to risky behaviours that may make the treatment seem unsafe or difficult to deliver, including self-injury and the increased tendency for suicide.
Finally, Monson will continue evaluating the best methods of training clinicians in the treatments she has developed. To increase access to her training programs across Canada, she plans to test novel online methods to enhance clinician learning and ultimately improve treatment outcomes for patients with PTSD.
Although psychotherapies for PTSD work for many, Monson acknowledges there is room to increase the number of individuals who may benefit from them. "We must keep pushing the envelope to find ways to help more people with the disabling disorder of PTSD," she says. "Our team is trying to fill these gaps by using technology to directly reach consumers and clinicians yet trained, and innovate ways to safely offer treatment to those who are most impaired.”
* Posttraumatic Stress Disorder in Canada by M. Van Ameringen, C. Mancini, B. Patterson and M. Boyle. Their article was published in the journal CNS Neuroscience & Therapeutics, 2008; 14(3):171-181