An Exploratory Analysis of Trauma and Substance Use Disorder Inpatient Treatment for Public Safety Personnel, Military Members, and Veterans.

Individuals who work within a public safety organization, as well as the military, are particularly vulnerable to mental disorders due to the psychological risks associated with their professions. There are evidence-based interventions that support the treatment and management of these occupational stress injuries (OSIs); however, less is known about the unique contributions of the specific components of these interventions when provided within an inpatient setting, particularly for occupation-specific populations. Therefore, a gap in the literature is determining what portion of the change observed in the service users can be attributed to the therapy itself versus optional elements of the treatment program. Inspired by the component analysis methodology, we conducted an exploratory observational study and examined the clinical outcomes for 345 inpatients at a mental health facility designed to treat post-traumatic stress disorder (and substance use disorders if present) in public safety personnel and active/retired military members. Overall, we found that service users demonstrated statistically and clinically meaningful improvements in their symptoms. Despite this, we did not see different results between service users who differentially participated in optional programming that included adjunct psychotherapy and exposure work, with the exception of participation in a specific holistic practice called integrative restoration which may support depressive symptoms specifically. Further research is needed to better understand what is contributing to the treatment outcomes and differences observed.