title: Nature adventure rehabilitation for combat-related posttraumatic chronic stress disorder: a randomized control trial.
abstract: Chronic combat-related posttraumatic stress disorder (CR-PTSD) is a condition with many treatment barriers. Nature Adventure Rehabilitation (NAR) as a second line or as a supplemental intervention has the potential to overcome some of these barriers and incorporate aspects of successful treatment modalities for PTSD within an experiential learning paradigm. In a pre-post controlled trial, CR-PTSD veterans (n=22) underwent a 1-year NAR intervention compared to a waiting list (WL) control group (n=20). Posttraumatic symptoms (PTS), depression, functional problems, quality of life, perceived control over illness (PCI) and hope were measured by self report measures. PTS, emotional and social quality of life, PCI, hope and functioning improved significantly. Change in PTS was contingent upon change in PCI. The current study is the first to present NAR as a promising supplemental intervention for chronic CR-PTSD. NAR seems to work through a process of behavioral activation, desensitization, gradual exposure to anxiety evoking situations and gaining control over symptomatology.
authors.affiliation: Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel; NATAL: The Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel.
authors.forename: Marc
authors.initials: M
authors.lastname: Gelkopf
authors.forename: Ilanit
authors.initials: I
authors.lastname: Hasson-Ohayon
authors.forename: Menashe
authors.initials: M
authors.lastname: Bikman
authors.forename: Shlomo
authors.initials: S
authors.lastname: Kravetz
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003130:Combat Disorders / Q000150:complications / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology / Q000534:rehabilitation; D015999:Multivariate Analysis; D011788:Quality of Life; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D014728:Veterans; D055815:Young Adult
keywords: CR-PTSD; Experiential learning; Nature Adventure therapy; PTSD; Rehabilitation