The Politics of Treatment: A Qualitative Study of Canadian Military PTSD Clinicians

Abstract

There has been an upsurge in post-traumatic stress disorder (PTSD) research, but these efforts have not included trauma clinicians. Using a constructivist grounded research methodology, we examined clinicians' views about military PTSD, their experiences in utilizing accepted interventions, and the personal impacts of this work. Our findings indicate that clinicians struggle with conceptualizations of PTSD, accepted treatments, and the requirements of navigating the Veterans Affairs Canada (VAC) bureaucracy. Demands to negotiate occupational realities while attempting care for clients underpinned experiences of emotional exhaustion. Contrasting the literature on secondary trauma, bureaucratic forces, implied expert status, and lack of supports for clinicians were at the root of exhaustion. Military trauma clinicians appear caught in the politics of treatment with detrimental effects on their health. This study is the first to explore clinician views on the benefits and costs of working with military trauma survivors.

Breaking Ranks: How Medically Released Canadian Military Veteran Men Understand the PTSD Diagnosis

“…In the civilian context, veterans reported that virtually all behaviors and choices are filtered through prevailing perceptions of PTSD. Importantly, our study shows that the struggle with the bureaucracy of Veterans Affairs and the politics of entitlement and treatment extend beyond the individual veteran through continual struggles over control (Finley, 2011;Gallagher, 2016;Whelan et al, 2021). Consistent with existing research on shame and stigma (e.g., Figley et al, 2011), veterans in our study reported shame and selfblame for failure prior to their military release about the PTSD diagnosis that left them feeling isolated from their peers.…”