Improving Provider Awareness and Utilization of Massage Therapy in Treating Post-Traumatic Stress Disorder (PTSD)

On average, 23% of veterans are diagnosed with post-traumatic stress disorder, (PTSD) and 22 veterans die from suicide each day (U.S. Department of Veterans Affairs, 2018) as a result of it. Current first-line treatment for PTSD is psychotherapy to address the cognitive patterns associated with PTSD. Second-line treatment is pharmacologic interventions to treat the biological symptoms. The corticolimbic circuit is affected in PTSD, leading to such common symptoms as increased fear learning, hyperarousal, numbing, agitation, lack of trust, flashbacks, and avoidance. Massage therapy has been shown to modulate the corticolimbic circuit resulting in stress relief, improved mood, and reduced aggression. Evidence suggests that massage therapy helps to alleviate both physical and mental health ailments, treating the mind and body in unison, which leads to better outcomes, particularly in trauma survivors. The goal of this DNP project was to increase VA outpatient mental health care providers' understanding about the benefits of massage therapy, resulting in an increased use of massage in PTSD treatment plans. Firstly, a comprehensive survey was administered to identify providers' existing awareness of, and confidence in, massage therapy in helping treat PTSD. An educational session was then presented to providers to encourage them to enroll patients in massage therapy. Information regarding the referral process within the VA system was also provided. The project's effectiveness was measured by mental health providers' knowledge of the benefits of massage therapy, using pre- and post-education surveys and increased referral to massage therapy services. Based on the results, the education sessions were successful at increasing awareness about the benefits of massage therapy and health care provider willingness to include massage therapy in treatment plans. The pre-education survey demonstrated an overall mental health provider awareness that PTSD is not adequately treated with current treatment options. Additionally, the majority of the mental health providers did not find long-term psychopharmacology treatments for PTSD to be superior to mind-body-based intervention. The post-education survey demonstrated a statistically significant difference of 48.8% increase in provider knowledge of massage therapy as an effective treatment option for PTSD. Health care providers demonstrated 52.7% increased knowledge of how massage therapy can alleviate symptoms of PTSD and 37.6% enhanced belief that they should include massage therapy among treatment recommendations. They also expressed a desire for future advancements in the use of massage therapy as a treatment option for PTSD. a willingness to refer veterans suffering from PTSD to a properly trained massage therapist. Four providers stated they had made referrals to massage therapy, and six providers stated they had included massage therapy in their treatment plan, compared to zero referrals pre-education. Despite a fairly small sample size in this project, the education sessions increased health care provider knowledge about the benefits of massage therapy. This project requires minimal funding by enriching knowledge through provided education module and utilizing current massage therapists or community referrals.