n keeping with its innovative tradition, the VA Palo Alto Health Care System opened the Women's Trauma Recovery Program (WTRP) in 1992 as part of the Menlo Park Division of the National Center for PTSD - the first program of its kind in the nation. The WTRP serves women of all eras and has expanded its treatment program to include war-zone related stress, as well as MST (Military Sexual Trauma) related to sexual assault while serving in the military.

The WTRP is an intensive 60-day residential program with a strong emphasis on interpersonal skills. Interpersonal demands, in addition to the intensity of trauma work, are at times too rigorous for some women with PTSD. Our response in these cases has been to establish a second track in the program that involves intensive skills building.

This more basic program places greater emphasis on psychoeducation and skills building classes and requires fewer interpersonal skills for successful program participation. The intensive trauma work is replaced by classes focusing on developing coping skills, affect management skills, relapse prevention, and increasing skills of daily living (financial management, goal setting, and problem-solving, etc.) The interpersonal demands might still pose a challenge to women who have been extremely isolative, and who find it particularly difficult to trust others. For those who appear unready for group treatment, specific recommendations are made to both the applicant and referring clinician regarding what skills and experience are needed to better match the applicant's current treatment needs.

The current program (i.e., the "intensive" track) continues to be an important part of our program offerings and will maintain its present format.

The initial two weeks of treatment involve psychological and psychosocial assessments in conjunction with group therapy related to problem-solving, effective communication, and identifying PTSD symptoms. It has been our experience that the psychological assessment process has significant therapeutic value in providing an opportunity for patients to begin talking about things important to them.