Understanding PTSD treatment
Do I need professional help?
Whether or not you need help can only be determined by you and a mental health professional.
However, you can take the self-assessment in the PTSD Coach Canada Application to see if you
are scoring in the high, medium or low range of symptoms. You can also ask yourself the
following questions. If you answer "yes" to any of them, then you might want to seek help.
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Have you felt sad or depressed most of the time for longer than two weeks?
Have you been feeling anxious or do you have distressing thoughts almost all the time?
Have you had trouble working or meeting your daily responsibilities?
Have you had problems in your relationships or trouble taking care of your family?
Have you increased your use of alcohol, street drugs or prescription medications, or
have you been using them to cope with your problems lately?
Are you very angry most of the time?
Do other people say they worry about you and think you should go talk to someone?
Are you having trouble sleeping most of the time?
Are you having trouble eating, or have you gained or lost a lot of weight without trying?
Do you currently have serious thoughts about suicide, or hurting or killing someone
else?
If you said "yes" to this last question, please call 9-1-1 or the suicide hotline in your area, visit
the Suicide Prevention website, or go to the nearest hospital right now.
If you said "yes" to any of the other questions, you could benefit from talking with a mental
health professional. You don't have to wait for an emergency to speak to someone.
Why do people usually seek professional help?
The first few weeks after a traumatic event can be hard. It is common to have trouble with life,
avoid situations, feel very nervous, and have trouble sleeping. But if you don't get better in the
first month, then you should think about talking to a mental health professional.
People close to you mean well, but they may not be able to help you the way you need. Maybe
you would like to talk with your friends and family, but you feel cut off from them right now.
Experiences like combat, witnessing suffering and dying, rape, assault, domestic violence, or
loss of a buddy, may feel too private or sensitive. You may feel uneasy or unsafe to talk with
someone you know.
One of the most helpful ways to feel better and get back on track is to work with a mental
health professional. However, many people don't seek counselling even though they might
benefit from it. Professionals who specialize in working with PTSD can help you learn to manage
your feelings and thoughts. They can also help you feel relaxed about talking to people in your
daily life, pursuing your goals and focusing on your future.
Keep in mind that seeking help is a sign of strength, not weakness. Talking to a mental health
professional can improve your ability to help yourself.
Will it really work?
Scientific evidence shows that many types of psychotherapy and medication really do work.
It may be hard to imagine now, but you can get past your stress. Therapy may also help ease
your transition back home. Like many others that have received counselling, there is a very
good chance that you will thank yourself later for sitting through a few uncomfortable hours.
If you are worried that mental health professionals can't help you or won't understand what
you have been through, you may be surprised to find out that this may not be true. Mental
health professionals are well trained. Some of them even specialize in working with military
personnel and Veterans, rape victims, or other special populations. They cannot help or
understand you if you don't give them a chance.
If you have a few sessions with a mental health professional and you don't think it's going well,
you can talk to the treating professional about what you want changed or you can ask for a
different one. Mental health professionals are interested in your recovery and will help you get
the help you need.
PTSD treatments that work
The good news is that there are several types of treatment that work for PTSD.
The best evidence supports cognitive-behavioural therapy (CBT) for PTSD. Two types of CBT
that have the most research behind them are cognitive processing therapy (CPT) and prolonged
exposure (PE).
Research also supports the use of eye movement desensitization and reprocessing (EMDR), and
finally, medications called selective serotonin re-uptake inhibitors (SSRIs).
If you have PTSD, you can look for a mental health professional who is trained in one of these
approaches.
What about practical things like finding a mental health professional, scheduling
appointments, costs and transportation?
When considering professional mental health services, many people worry about practical
things that may keep them from getting help. Concerns about how to find a mental health
professional, the cost of treatment, getting time off from work, and transportation to
appointments are very common. Each is addressed briefly below.
Finding a mental health professional
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A good place to start your search for a mental health professional is to ask your doctor.
They can make a referral for you.
If you are a Veteran, you can also call Veterans Affairs Canada at 1-866-522-2122 and
ask for recommendations.
If you are a Canadian Armed Forces (CAF) member, a CAF health services centre is a
good place to start your search. Every CAF medical clinic offers two levels of mental
health care; psychosocial and specialized mental health programs. The Psychosocial
Program provides first line services that CAF members can directly access on their own
at any time.
The Canadian Forces Health Information Line is available to all eligible CAF members. It
is operated on a 24 hour a day, 7 day a week basis, and is designed to provide CAF
members with convenient telephone access to health care advice, general health
information, and guidance on where and how to access health care services. Call 1-877MED-DENT (1-877-633-3368)
Costs
Try not to worry about how much therapy will cost, until you have all the details. Think of
therapy as an investment in your health and well-being. It can help you live a happier, fuller life.
Veterans Affairs Canada may be able to pay the cost of counselling for Veterans with servicerelated disabilities. Services at CAF health services centres are also provided at no cost to
serving members of the CAF.
Scheduling appointments
If you need flexible appointments so you do not miss work, look for a mental health
professional that will accommodate your schedule. You want to find a time that works for you
and where you won't feel rushed. Most employers will understand and help you take care of
your health, whether it's physical or emotional. Often, people can work out a flexible schedule
with their boss to free up time for their appointments.
Transportation
If getting to and from appointments is a challenge, there may be travel options available to you,
including simple things like public transportation or asking friends or family members to help.
You might be surprised at how many people will take the time to help you get to an
appointment. Veterans Affairs Canada may also reimburse health-related travel costs for
Veterans with service-related disabilities. Health-related travel costs for CAF members will also
be covered by the CAF health services centre making the referral.
Why should I ask for help?
Remember that we are not alone in this world. People are here to help. Perhaps you believe
that you can handle your problems without help from others. But, people who use the sources
of help around them tend to cope better than those who don't. Trying to cope on your own
usually makes things harder than needed; and it adds loneliness and isolation to your problems.
You may think that needing help means that you're not normal. It is common to experience
problems and many people report some type of concern about their mental health after
stressful experiences.
Seeking professional help and talking about your experiences can help you feel better and
stronger. And getting the support you need to live your life more fully shows strength, selfrespect, growth and courage.
What if I'm embarrassed about seeking help?
You don't have to tell anyone that you are working with a mental health professional. You can
just say that you have an appointment and that it's personal. Sharing that information is your
choice.
Try not to be upset with people that worry about you. Their concern can come from a good
place and wanting good things for you. They may be on your side even if it doesn't appear that
way to you.
Put yourself in their shoes. Think of a moment when a friend was having a hard time. Did you
judge them for it, or were you glad that you could help? Friends, as well as family, usually want
the best for you and are probably looking for ways to help you.
You may think that people will judge you for getting help, because at one point you may have
overheard someone making fun of someone in your situation. But you will come to find out
that this usually isn't true. It's normal to have problems whether you are a civilian or someone
who has served your country. Many men and women report some concern about their mental
health.
Believing that they will be embarrassed and ashamed for asking for help is the biggest reason
that people, including service members and Veterans, don't seek help. But, take a minute to ask
yourself the following questions: Is it more important for me to worry about what someone
else thinks of me? Or, is it more important to get the help I need to move on with my life?
Who can help me?
As you think about getting care, know that there are many experts to help you. The following is
a brief description of the roles and duties of primary care physicians, social workers,
psychologists, psychiatrists, and pastoral counsellors or chaplains.
What does a primary care physician do?
Family physicians and general practitioners (family doctors) are medical doctors who specialize
in primary care. They are available in both the Canadian Armed Forces and civilian
communities. Family doctors provide lifetime, comprehensive care for individuals and families
across all ages. They are a good first contact to help you with your problems, and to help you
find the services you need. They diagnose symptoms to sort out physical and mental health
causes, and provide treatment considering your family and community life. To help with
psychological problems, family doctors prescribe medications and provide basic therapy, and
they collaborate with psychologists, psychiatrists and other mental health professionals when
more specialized mental health diagnosis and treatment is required.
What does a social worker do?
Social workers work with people who are struggling with depression, anxiety, PTSD and
substance use problems. They also help people with more severe mental health issues, and
family and relationship difficulties. Social workers help clients with other challenges including
finding employment, housing and government benefits. Their services may include
psychotherapy or "talk therapy," mediation, sex therapy, policy and program development,
organizational development, and employee assistance programs.
Social workers are not medical doctors and cannot prescribe medications. In most provinces,
the Bachelor of Social Work is the minimum educational requirement for entry into the
profession. Post-graduate education leading to a master's or doctoral degree is also available.
In Canada, social work legislation is the responsibility of the provinces and territories. Social
workers work in a variety of settings: family services agencies, children's aid agencies, general
and psychiatric hospitals, mental health programs, school boards, correctional institutions,
welfare administration agencies, as well as federal and provincial departments. An increasing
number of social workers work in private practice. You can find a social worker through advice
from people you know or referrals from a doctor, a nurse or your insurance company. A social
worker can help if you need someone to help you get back on track with getting a job, housing
or government benefits, or if you just need someone who will listen and refer you to an expert.
What does a psychologist do?
Psychologists work with clients who have many concerns, including depression, anxiety, PTSD
and substance use problems, as well as other mental health issues. Psychologists work with
individuals, couples, families and groups. They help people deal with life problems such as
family and relationship problems. Licensed psychologists most often have a Ph.D. or Psy.D. in
psychology or a related field. This takes about five years after the university undergraduate
studies to complete. They must also complete supervised professional experience. In Canada,
psychology legislation is the responsibility of the provinces and territories. Although
psychologists are often called doctors, they are not medical doctors and cannot prescribe
medications. Their role is to provide assessment and psychotherapy. There are psychologists
working in institutions, in the community and in health care throughout the CAF and at
Veterans Affairs Canada. You can find a psychologist through advice from people you know or
referrals from a case manager, doctor, nurse or your insurance company.
What does a psychiatrist do?
Psychiatrists are medically trained to diagnose, treat and provide ongoing care for mental
health conditions to patients of all ages. A referral from a medical professional is often required
to access services from a psychiatrist.
Psychiatrists work in a range of settings including psychiatric or general hospitals, private
offices, research units, community health centres, social agencies and government.
Psychiatrists use a mix of treatment options, including medications and psychotherapy,
depending on the psychiatric conditions. Often part of the treatment or rehabilitation plan will
include referral to or collaboration with a range of other services.
What does a pastoral counsellor or chaplain do?
A pastoral counsellor or chaplain is a member of the clergy who provides spiritual support and
guidance, conducts religious services in the field, and offers support in emergency situations.
Chaplains help people regardless of their faith or religious beliefs. Chaplains are not always
trained to provide mental health counselling, but they can refer you to a general practitioner or
a specialist, like a psychologist or a social worker, who can help you address your emotional
difficulties more thoroughly. If you are looking for spiritual guidance as part of your road to
receiving professional care, then perhaps a pastoral counsellor or chaplain is a great start for
you.
Where can I find professional care near me?
Most communities, especially cities and large towns, have many different sources of help.
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If you feel desperate and need help immediately, you should call or go to the emergency
ward of your local hospital;
Your telephone book will have the phone number of a community service referral
agency and the number of a crisis hotline that you can call;
Your family doctor can help you find the professional help you need;
Contact a community organization specializing in support can provide information or
help direct you to a mental health clinic in your area; or
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Contact the Canadian Mental Health Association (CMHA). Founded in 1918, it is one of
the oldest voluntary health organizations in Canada. As the nation-wide leader and
champion for mental health, the CMHA facilitates access to the resources people
require to maintain and improve mental health. The CMHA has more than 10,000
volunteers and employees across Canada in over 120 communities. For mental health
information, resources and tools and for a list of mental health services in your area,
please find a CMHA community location nearest you.
Other support
Operational Stress Injury Social Support (OSISS)
Want to talk to someone who is experienced and trained in offering peer support to those with
an operational stress injury? If you are a Canadian Armed Forces member, a Canadian Veteran
or a family member, OSISS peer and family support coordinators may be able to help you. For
the OSISS coordinators in your area, visit the OSISS website or call 1-800-883-6094.
Veterans Affairs Canada Assistance Service and the Canadian Armed Forces Member
Assistance Program (CFMAP)
Employee Assistance Services of Health Canada is the service provider for the Canadian Forces
Member Assistance Program (CFMAP) and the Veterans Affairs Canada Assistance Service. This
line is staffed 24 hours a day, 365 days a year, by fully-trained bilingual counsellors. It provides
free, confidential, voluntary, short-term, solution-focussed counselling services to assist current
and former members of the CAF and their family members with support to resolve many
common psychosocial stresses. Within Canada and the United States you can call them toll-free
at 1-800-268-7708. If you are calling from another country, you must dial the International
Access Code first + 800-268-7708.
Services and benefits from VAC
We recognize that when you serve with the CAF the work you do is unique. That's why Veterans
Affairs Canada has a variety of services and benefits available to support you. Whether you are
still serving and have been injured, are medically releasing or are retiring and would like help in
your transition to civilian life, Veterans Affairs Canada is here to help.
Services for Canadian Armed Forces members
CAF Health Services is the main providers of mental health services for CAF members. The
Psychosocial Program is available at all CAF medical clinics. Social workers, mental health nurses
and addiction counsellors normally staff the Psychosocial Program. The Mental Health Program,
which consists of specialized mental health services, is available at the larger CAF bases, with
elements of the program available at smaller bases. After regular office hours, members are
advised to contact their local hospital emergency department.
The Canadian Armed Forces Health Information Line is available to all CAF members. It is
operated on a 24 hour a day, 7 day a week basis, and is designed to provide you with
convenient telephone access to health care advice, general health information, and guidance
on where and how to access health care services. Call 1-877-MED-DENT (1-877-633-3368)