title: Utilizing Telehealth to Support Treatment of Acute Stress Disorder in a Theater of War: Prolonged Exposure via Clinical Videoconferencing.
abstract: BACKGROUND
  Posttraumatic stress disorder (PTSD) and acute stress disorder are prevalent mental health diagnoses associated with the military operations in Iraq and Afghanistan and are especially significant in service members returning from combat. Prolonged exposure (PE) therapy is a highly effective behavioral treatment for these symptoms, and providing this treatment as soon as possible, even in the midst of a soldier's combat deployment, has strong potential benefits.
  
  
  METHODS
  In the current case study, telehealth technology was used to support the delivery of PE therapy to treat a service member diagnosed with acute stress disorder in a war zone. PE was conducted face-to-face on the relatively secure Forward Operating Base for the first half of therapy and via clinical videoconferencing (CV) to the service member's remote combat outpost during the later stages of therapy. The service member exhibited marked improvements in symptoms over 10 sessions.
  
  
  RESULTS
  Results are consistent with previous empirical findings and highlight the potential benefits of using telehealth to deliver evidenced-based treatment for traumatic stress disorders in a war zone. This case study provides a preliminary working model for delivering PE in a combat environment using multiple delivery systems.
  
  
  CONCLUSIONS
  Benefits and clinical utility of CV-delivered exposure therapy are discussed, particularly for providers pending future operational deployments (e.g., including members of the military, independent government agencies, and first responders) and for those treating patients in remote locations.
authors.affiliation: 1 U.S. Army Individual Ready Reserve .
authors.forename: Dan
authors.initials: D
authors.lastname: Pelton
authors.forename: Bethany
authors.initials: B
authors.lastname: Wangelin
authors.forename: Peter
authors.initials: P
authors.lastname: Tuerk
mesh_terms: D000328:Adult; D000346:Afghanistan; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007493:Iraq; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration; D015397:Program Evaluation; D011613:Psychotherapy / Q000379:methods*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D017216:Telemedicine / Q000458:organization & administration*; D013997:Time Factors; D016896:Treatment Outcome; D049269:Videoconferencing / Q000458:organization & administration*; D014857:Warfare
keywords: behavioral health; disaster medicine; military medicine; telepsychiatry