Expanding care for service members and their families

The Center for Deployment Psychology isn't only a training resource, says Cynthia D. Belar, PhD, executive director of APA's Education Directorate. It's a case study in the power of advocacy.

The idea for the center came from the Education Directorate's Government Relations Office, which helped establish it in 2006. Three years later, the center is thriving, with a larger staff, more stable funding and an ever-increasing audience for its psychology training.

"This is an excellent example of how education advocacy can have a broad impact," says Belar. "The center was designed to improve quality of services through the training of psychologists and other health professionals in deployment psychology and relevant evidence-based treatments. In addition, it has created a number of new positions for psychologists."

A training mission

Headquartered at the Uniformed Services University of the Health Sciences in Bethesda, Md., the Center for Deployment Psychology also has 10 satellite sites at military medical centers with APA-accredited psychology internship programs.

Their ultimate goal? "To improve the treatment that's available for service members and their families when they're dealing with deployments—especially combat deployments—and their consequences," says psychologist David Riggs, PhD, the center's executive director.

The central training experience is a two-week course held at USUHS and Walter Reed Army Medical Center. The course offers an intensive grounding in the stressors that military personnel and their families face, plus in-depth information on assessing post-traumatic stress disorder, caring for patients with traumatic brain injuries and addressing depression, substance abuse and other issues that often arise during deployment. The course also offers tips for handling providers' own deployment.

So far, the program has trained about 500 psychologists, interns and other mental health providers working in Department of Defense or Department of Veterans Affairs facilities.

But the center doesn't just train military psychologists. A year ago, it began offering a one-week course to prepare civilian mental health providers to assist military personnel and their families.

"We were concerned about the number of service members who won't seek care through military providers," explains Riggs. "They're worried about the stigma associated with seeking care and afraid that information might get back to the folks on post or on base. Or, especially for vets who have been out of service or for National Guardsmen or reservists who go back to their communities, they can be nowhere near military providers."

In addition to the clinical issues, the programs introduce health-care providers to military culture. "We raise awareness of the types of stressors that are placed on military families over the course of a military career, which could include deployment, multiple deployments and the fact that frequent moves mean kids are changing schools," says Riggs. "We've received very positive feedback."

To date, the center has offered about 10 of these courses around the country, reaching up to 125 civilian providers at a time. The center also offers specialized training upon request. Its mobile training teams offer two- or three-day workshops on PTSD and similar topics, usually in partnership with a hospital or clinic.

The center's funding has increased along with its target audience. Instead of having to rely on an annual appropriation from Congress, the center now receives its funding directly from the Department of Defense.

"It has been so successful that it was incorporated into the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury," explains Nina G. Levitt, EdD, director of APA's Education Government Relations Office. "That means tremendous stability."

That funding shift has allowed the center to expand, adds Riggs. The center began with two professionals and one support staff at its headquarters, plus 10 staff in the satellite sites around the country. The headquarters staff has since grown to eight, with two more employees scheduled to join the staff. And because the Navy is reopening a previously inactive internship site, the center plans to hire another staff member for that program.

Future directions

What's next for the center? Finding ways to use the Internet or other distance learning technologies to keep expanding access to training, says Riggs. The center already has online courses available through its Web site (deploymentpsych.org/index.html). A course is also available for continuing-education credit through APA's site, says Riggs.

Expanding distance education will be key to training far-flung health-care providers. "Military providers may not be able to leave their duty station for two weeks to come to Bethesda," he says. "Oftentimes, they may be the only mental health provider at that base. Or they may be overseas." Civilian contractors, who often can't get funding to attend the courses in person, are another target audience for online efforts.

Another goal is to develop a secure online consultation system that would allow training graduates to ask questions and exchange ideas. An ask-the-experts page, available to the public, could supplement the consultation system.

"We realize that getting people to adopt new practices is going to take more than just standing up and teaching them about those practices," says Riggs. "We have to provide some support as they're starting to implement these things."

The center will also continue to fine-tune its existing training. Past program evaluations have shown that "people like what we do and seem to learn," says Riggs. Now the center is developing a survey for graduates to see what they've actually put into practice.

For APA's Levitt, the center is already fulfilling the vision she had for it three years ago. "This is really something psychologists can be very proud of," she says.

Rebecca A. Clay is a writer in Washington, D.C.