Our Research

We aim to conduct high quality robust research to ensure we are delivering the best possible services for our veterans, in line with our values. The research department is led by Dr Dominic Murphy and we are committed to publishing our research in external peer-reviewed academic journals as part of our commitment to contribute to the advancement of the veteran mental health field. We work closely with Kings Centre for Military Health Research at Kings College, London to ensure our research is of the highest standards.

We are grateful to many of our clients who consent to take part in our research and we are always dedicated to preserving your confidentiality and respecting the voluntary nature of your participation.

See below a summary of our published journal articles:

Effectiveness of our Treatment Programmes

Ensuring our treatment programmes improve the mental well-being of veterans is central to what we do. On an on-going basis, we consider how effective our programmes are and what makes them more effective.

Year 

Title

Summary

2016

Long-term responses to treatment in UK veterans with military-related PTSD: an observational study

  • We assessed 1-year outcomes in 268 UK veterans treated for PTSD.
  • PTSD symptom severity, depression, anxiety, alcohol use and difficulties with social and occupational functioning remained lower than before treatment.
  • There are long term benefits to structured treatment programs.
  • Support targeted at individuals after treatment will improve longer term outcomes.

2016

An adapted imaginal exposure approach to traditional methods used within trauma-focused Cognitive Behavioural Therapy, trialled with a veteran population

  • The study investigated a new method of therapy for PTSD with 2 veterans from Combat Stress.
  • An adapted imaginal exposure approach was used whereby veterans relive their experience outdoors, manipulate their perspective on the imagery and restructure how they think about it.
  • It showed that imaginal exposure therapy can help veterans who experience avoidance or dissociation.

2015

Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD)

 

  • 246 veterans were assessed after finishing the six week treatment programme and then again at a six month follow up.
  • There were improvements in PTSD symptoms following the treatment and also after six months.
  •  The study suggests it may be beneficial to combine individual therapy with group sessions.

 

2015

Exploring Outcome Predictors in UK Veterans Treated for PTSD

  • Study on 244 veterans who received the six-week residential treatment programme for PTSD at Combat Stress.
  • It was found that PTSD symptoms including avoidance, hyper-arousal and intrusive thoughts were reduced after the programme.
  • The study also showed that treatment outcomes were better in veterans who had lower levels of anxiety and dissociation.
  • Therefore it is important to treat other difficulties such as anxiety and dissociation before PTSD.

Accessibility of Treatment

Our programmes should be available to all veterans who need them so we look at who is accessing our services, how this is changing and what may influence this.

Year 

Title

Summary

2016

Detailing the clinical pathways at Combat Stress for UK veterans experiencing symptoms of complex post traumatic stress disorder.

  • This paper explains the three different stages of treatment at Combat Stress.
  • The first stage is known as ‘stabilisation’ where veterans attend a two week programme.
  • The second stage is trauma therapy, known as the ‘intensive treatment programme’ which lasts six weeks.
  • The third stage is to ‘reconnect veterans with their lives’.

2015

Exploring Patterns in Referrals to Combat Stress for UK Veterans with Mental Health Difficulties between 1994 and 2014

  • A fourfold increase in the number of referrals was found over the 20 years examined.
  • This shows that more veterans are seeking help for mental health problems than before.
  •  It was found that the time taken to seek help reduced by half.
  • Also, although the majority of referrals were from veterans who had served in Northern Ireland, recently there have been more referrals from veterans from Iraq and Afghanistan.

2014

Exploring positive pathways to care for members of  the UK Armed Forces receiving treatment for PTSD: a qualitative study

  • The study interviewed serving military personnel who were seeking help for mental health problems about what triggered them to seek help.
  • Five common reasons were found for seeking help: having reached a crisis point, overcome shame, felt in control, wanted to find a psychological explanation for their symptoms and had good social support.

2014

PTSD, stigma and barriers to help-seeking within the UK Armed Forces

  • The paper explores existing literature on the impact of untreated PTSD in military personnel.
  •  It also looks at barriers as to why people may not seek help and interventions to address these barriers.
  • Stigma is found to be the greatest barrier, in particular having negative beliefs about oneself.

Understanding Veterans

In order to make sure our treatments are tailored to the needs of veterans, we conduct research to help us understand their specific problems and how they differ to other people who experience mental health problems.

Year 

Title

Summary

2016

Do alcohol misuse, service utilisation, and demographic characteristics differ between UK veterans and members of the general public attending an NHS general hospital?

  • A comparison of substance misuse between UK veterans and the general public
  • 2,331 individuals with alcohol misuse problems were referred for specialist support
  • They were assessed for difficulties, dependency levels, withdrawal symptoms, other substance misuse and service utilisation
  • No differences in severity were found between veterans and the general public
  • However, it was found that veterans were referred at an older age and admitted to hospital for longer than non-veterans

2016

Experience of post-traumatic growth in UK veterans with PTSD: a qualitative study

  • This study examined positive change in veterans after experiencing trauma (aka. Post-traumatic growth).
  • It was found that veterans understood positive growth to have occurred after being treated for PTSD.
  • The paper found common areas of improvement in differences in the meaning of negative feelings and experiences, appreciation of the world, connecting with others and re-evaluating their sense of purpose.

2016

Post-traumatic growth among the UK veterans following treatment for post-traumatic stress disorder.

  • This study examined positive change in veterans after experiencing trauma (aka. Post-traumatic growth).
  • 149 veterans answered questions on their mental health before treatment and 6 months after treatment at Combat Stress.
  • An association was found between better treatment response and higher reported levels of post-traumatic growth.

2015

Prevalence and Associations Between Traumatic Brain Injury and Mental Health Difficulties Within UK Veterans Accessing Support for Mental Health Difficulties

 

  • Out of 123 veterans seeking help with Combat Stress, 63% reported having a traumatic brain injury.
  • No relationship was found between having a traumatic brain injury and post-concussion symptoms.
  • However, a link was found between having a traumatic brain injury and depression or anger problems.

Art Therapy

Art therapy can help make it easier for veterans to express themselves, especially when they find it hard to talk about thoughts and feelings. Research has shown that art therapy can help reduce stress, anxiety and increase awareness and self-esteem. Therefore we aim to look into how effective it is for veterans and how it can be improved.

Year 

Title

Summary

2016

Factors that influence engagement in an inpatient art therapy group for veterans with Post Traumatic Stress Disorder

  • Two surveys were conducted on 29 veterans at combat stress
  • The first looked at why people did or did not attend all sessions
  • The second survey looked at the benefits of art therapy sessions
  • It was found that 100% of the 19 veterans in survey 1 preferred to do emotional work in individual sessions
  • 100% of the 10 participants in survey 2 found the sessions relaxing
  • Veterans said they were able to overcome anxiety and develop new ways of thinking

2014

The invisible wound: Veterans’ art therapy

  • Qualitative analysis of veterans comments during an art therapy session
  • Disconnection, avoidance, control and presenting a mask were identified as problems
  • Art therapy helped them connect, share fears and anxieties, deal with feelings and drop their masks
  • Veterans bonded as a ‘band of brothers’ and felt supported and understood

  Research Logos