Trauma Management Therapy for a Veteran With Co-Occurring Combat PTSD and Hallucinations

Despite the development of evidence-based treatment protocols for posttraumatic stress disorder (PTSD), many clinicians are hesitant to begin trauma-focused treatment for individuals presenting with co-occurring conditions, particularly disorders with psychotic features. The current clinical case describes the treatment of a male veteran with PTSD with hallucinogenic features and recurrent depression who was treated with Trauma Management Therapy, a comprehensive treatment program for combat-related PTSD incorporating virtual-reality assisted exposure therapy and group therapy. Following treatment, the veteran demonstrated clinically significant decreases in overall PTSD symptoms as well as combat-themed hallucinations. Treatment gains were maintained at the 3-month follow-up. This case illustrates how exposure therapy can safely and effectively be delivered to individuals with complex co-occurring conditions.