Recent studies suggest that cognitive and behavioral interventions have enduring effects that reduce risk for subsequent symptom return following treatment termination. These enduring effects have been most clearly demonstrated with respect to depression and the anxiety disorders. It remains unclear whether these effects are a consequence of the amelioration of the causal processes that generate risk or the introduction of compensatory strategies that offset them and whether these effects reflect the mobilization of cognitive or other mechanisms. No such enduring effects have been observed for the psychoactive medications, which appear to be largely palliative in nature. Other psychosocial interventions remain largely untested, although claims that they produce lasting change have long been made. Whether such enduring effects extend to other disorders remains to be seen, but the capacity to reduce risk following treatment termination is one of the major benefits provided by the cognitive and behavioral interventions with respect to the treatment of depression and the anxiety disorders.
It is vital for mental health professionals serving veterans to be able to address the full range of needs presented by returning veterans, including those that affect a veterans' daily life (e.g., relationships, employment, and community functioning) but may not rise to the level of requiring specialty mental health care. This article describes the development and evaluation of an innovative Veterans Affairs program, Moving Forward, which focuses on building resilience and reducing emotional distress. Moving Forward is based on the principles of problem-solving therapy that have been adapted for use in a four-session, classroom-based training program for veterans. The program evaluation results indicate that Moving Forward is feasible, well-received by veterans, and yields improvements in social problem solving, resilience, and overall distress levels. Although there is a strong evidence base for problemsolving therapy in a range of clinical settings and with a variety of patient populations (Nezu et al., 2013), this represents the first effort to apply these principles in a program focusing on the readjustment and resilience of our nation's veterans. We include several recommendations for building on these results, including the use of Internet-based training, inclusion of family members in training, and recommendations for research in this important area.
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