WHAT IS RESOLUTION?

The Resolution project is a new approach to military PTSD. Radical, highly focussed and shown to be extremely effective in the 2007 Falklands Veterans' pilot programme, Resolution can remove the worst symptoms of PTSD in most cases, even after many years of suffering, leaving people free to get on with their lives. Having shown to the satisfaction of everyone who took part that this treatment works, we consider it is now a humanitarian necessity to make it available to everyone who wants it.

WHO ARE WE?

Resolution is a joint venture between two charities: the Falklands Veterans Foundation [FVF] and the Human Givens Foundation [HGF]. The FVF was the first organisation for Falklands Veterans, committed to providing them and their families with social and practical support. The HGF is a mental health charity that conducts research into innovative treatments for psychological problems, aiming to break the mould of mental health treatment and inject some fresh energy into the search for better solutions to our society's difficulties. One product of the HGF is HG Therapy for Trauma [HGTT], the method the Resolution project has been using with Falklands veterans during the pilot project.

WHAT IF I NEED HELP BUT HAVE NOT BEEN IN THE SERVICES?

We also receive inquiries from people who are suffering nightmares as a result of car accidents, mortuary experiences, bank raids, police or fire service duties, natural disasters, and so on. We cannot fund these cases directly, but the sometimes an employer or a relevant benevolent association will help, in which case we will take on the case and manage it in the same way as for our military clients.

HOW DOES THE RESOLUTION SERVICE WORK?

If you are suffering from nightmares, panic attacks, flashbacks, mood swings, irrational anger, depression or any other symptoms which have come on since exposure to an unpleasant event or events, you can contact us directly on 0845 021 7873. A case manager will talk (and listen!) to you and find out a little about your symptoms. We will then arrange for you to talk to a Serviceman or woman, if possible from the same arm of the Forces, who has been treated and is now better. He or she will explain what the treatment entails and how it worked for them. When you are happy you want to proceed, we arrange the first appointment with a practitioner. We have a network of 150 practitioners, highly experienced in this kind of PTSD work, so we can usually arrange treatment reasonably close to where you live.

HOW MANY SESSIONS DOES IT TAKE?

We are dealing with human beings so there are no absolute rules. However, experience from the Falklands Veterans’ Foundation / Human Givens Foundation pilot programme suggests that most people will need two sessions, but that three or even four sessions will occasionally be beneficial. The bulk of the intrusive symptoms (nightmares and flashbacks) are generally resolved after the first session.

WHAT IS THE TREATMENT?

You do not have to tell anyone what happened. You do not have to write down your trauma. You do not have to sit with a group and hear about other people's problems. We will teach you a relaxation technique (our experience is that even the biggest strongest men can be taught to relax, and they enjoy it when they discover how easy it is), then you will be guided through a visualisation technique which allows for safe and controlled re-exposure to the traumatic memories while reducing the anxiety connected to them. This is done extremely carefully so that you remain comfortable throughout.

This is unlike 're-living', or 'virtual Iraq', or 'imaginal exposure', in that one of the therapist's primary concerns is that you remain reasonably calm and relaxed throughout. The session takes about an hour, and you will need two to four of them. Then it is done. You won't forget the trauma, you can't change the past, but you will find it easier to put those times back in the past where they belong, they won't be travelling with you any more. Over a short time after treatment you will probably find you have more room in your head to do things you want to do, and that everyday tasks seem easier.

HOW WELL DOES IT WORK?

It's too soon for formal trial results, though a number of trials of the method are already under way. Anecdotally, the results are extremely good. The graph below shows how the first six people in the HGI-FVF PTSD evaluation got on.

For each person there are two columns, showing their arousal, avoidance and intrusion scores before and after treatment. You can see that all the total scores improve after treatment. One of the most important effects for most people is shown in the blue bars - reduction in the nightmares, flashbacks and unwanted memories of the traumatic events. In case 6 this effect is not so pronounced, but there is still a worthwhile improvement and the patient feels better than he did. Watch this space - new results will be added here as they come in.

This result agrees with the earlier Red Poppy Company result from 100 civilian trauma victims, where the average improvement was from a total score of 58 before treatment to an average of 12 afterwards, and with the recent Barnardo’s NOVA project report in Northern Ireland.

Importantly, as the technique is built around relaxation, the resulting sense of calm is useful even in the small percentage of people whose intrusive symptoms do not resolve with this method, so there is likelt to be some gain even for the non-responders in most cases.

HOW DOES THIS FIT IN WITH COMBAT STRESS?

Resolution is not in any sense in competition with Combat Stress – the service we offer is complementary to theirs and completely different.

Combat Stress offers invaluable long-term support to ex-service personnel, many of whom go to its residential facilities many times over several years and really enjoy the camaraderie and quasi-military atmosphere.

Resolution is an out-patient service using a radical new treatment model, which our pilot shows is capable of alleviating PTSD symptoms in a very small number of sessions in most cases. This does not suit everyone, but is enormously useful for those who prefer to take a brief course of treatment and then turn their attention to something else. We hope that this new initiative will take some of the pressure off Combat Stress.

IS THIS LIKE EMDR OR EFT?

A little. Eye Movement Desensitisation and Reprogramming [EMDR], Emotional Freedom Technique [EFT] and the HG treatment Resolution uses all appear to tap into the same underlying mechanism. We find the new approach much faster and easier to control, although there is a small number of people who do not respond to it and may benefit from these other approaches.

IS THIS LIKE CBT?

Again, a little, although it is hard to be exact about this as 'trauma-focussed CBT' is not precisely defined. CBT for trauma may or may not include relaxation, re-exposure and guided imagery, along with the traditional cognitive elements like cognitive re-structuring. So, some CBT practitioners would recognise our method as a possible variant of 'trauma-focussed CBT', others would not. In our view it's what you do that matters, not the label it goes under. Our treatment offers carefully controlled re-exposure and reframing during deep relaxation; elements that you will find in some trauma-focussed CBT clinics. We don't call it trauma-focussed CBT to avoid confusion with the other things are done under that label.

WHERE DID THE IDEA COME FROM?

This techniques owes its genesis ultimately to the fertile mind of Milton H. Erickson, who realised that the key to trauma is to re-visit it while the patient is extremely calm. Richard Bandler developed this idea, calling it the V/KD [Visual/Kinaesthetic Dissociation] technique, and used it for phobias. David Muss adapted it again, calling it the Rewind, and published a brief paper on its use in trauma in 1991. Griffin and Tyrrell of the HGI added two vital extra steps to the rewind itself and proposed using it inside the RIGAAR structure which is the backbone of Human Givens therapy sessions. This turns out to be vital: a recent study by Martin Murphy at the Barnardo's NOVA project shows that the rewind by itself is not enough to bring a proper resolution to trauma cases.

IS IT AVAILABLE ON THE NHS?

Not widely, as yet, though there are some NHS settings that are pioneering it. Generally, the NHS offers treatments based on guidelines issued by the National Institute for Health and Clinical Evidence [NICE]. These guidelines are based on trial results accumulated over many years, and inevitably tend to focus on historic treatment ideas, like CBT. Any radical approach is bound to take time to filter into the mainstream, so it could be some time before sufficient formal trials have been held for this approach to enter the NHS widely. However, something new is needed now, which is why the Falklands Veterans’ Foundation and the Human Givens Foundation have decided to form this project, cutting through years of process to make an urgently needed treatment available today.

I HAVE HAD PTSD FOR 25 YEARS - IS IT TOO LATE?

Absolutley not, start now and if you respond well you could be free of nightmares in a week. Long-term trauma symptoms are treated in the same way as things that happened yesterday, and while long-term and complex trauma may take longer to resolve than 'clean, single-incident PTSD', the principles of treatment are just the same.

WHAT ABOUT THE NON-RESPONDERS?

A small number of people will not find it possible to do the visualisation exercise, and a small number will not get the dramatic reduction in intrusive symptoms that most people experience. One NHS psychiatric unit that uses this technique with veterans estimates the non-responder rate to be about 5% in all. However, even these cases will usually benefit from learning the relaxation techniques that are a prelude to the de-traumatising.

I CAN NEVER RELAX

You almost certainly can, given the right opportunity. Leave it to us.

WILL IT LAST?

It is always possible for someone to be traumatized again, or for latent PTSD to be activated by another life experience that does not seem traumatic in itself, so we cannot say categorically that someone who has been treated in this way will never develop post-traumatic symptoms again. However, we do not know of any case where PTSD symptoms have re-emerged spontaneously, and if someone does develop further symptoms following another incident, it can always be treated in the same way as the original trauma.

CAN IT REALLY WORK THIS WELL?

Ask someone who has been through it. If you are a sufferer or someone else with a genuine interest in military PTSD we will arrange for you to speak to someone who has been to hell - and back - and who really knows what they're talking about.

Published by the Resolution project on behalf of the Human Givens Foundation, registered charity no. 1108432 and the Falklands Veterans Foundation, registered charity no. 1094950. The Falklands Veterans Foundation registered office is at 167 Stoke Road, Gosport, Hampshire, PO7 1SE. The Human Givens Foundation registered office is at Church Farm Lane, Chalvington, Sussex, BN27 3TD.