No abstract

Both PTSD and TBI commonly occur in the general population, both share some pathophysiological characteristics and both are associated with cognitive impairment and sleep disruption. PTSD and TBI present with a number of overlapping symptoms, which can lead to over-diagnosis or misdiagnosis. Both conditions are associated with co-morbidities important in diagnosis and treatment planning. More research is needed to elucidate what treatments are effective in PTSD and TBI co-morbidity and on factors predictive of treatment success.

This article describes the three-generation family systems health care model developed at the Veteran and Family Clinic of the Home Base Program, a partnership between the Red Sox Foundation and Massachusetts General Hospital designed to improve treatment engagement of veterans with posttraumatic stress disorder (PTSD) and related conditions, and to provide care to the entire military-connected family. This clinical model was designed to address 3 interdependent facets of the PTSD-affected family system: (a) the multiple attachment relationships that are often strained; (b) the veteran's family roles, which may be impaired; and (c) the multiple pathways for treatment engagement and amelioration of the veteran's PTSD-related distress and behaviors within the family system. In addition, we describe the assessment system, designed to probe the interrelationships of individual veteran, couple, parenting, child, and family levels of functioning. Three cases illustrative of the three-generation model's clinical application, how it can address unmet needs, and its ability to overcome barriers to health care for military families are also discussed.