Retraining the Brain

Retraining the Brain

Sheila Rauch, PhD, ABPP - ADAA Board Member

Member Since 2002

Sheila A.M. Rauch, Ph.D., ABPP, led design and now serves as Deputy Director of the Emory Healthcare Veterans Program and Director of Mental Health Research and Program Evaluation at the VA Atlanta Healthcare System. Dr. Rauch has been developing programs, conducting research and providing PTSD and Anxiety Disorders treatment for over 20 years. Her research focuses on examination of mechanisms involved in the development and treatment of PTSD and improving access to effective interventions. She has led several PTSD treatment outcome and mechanisms trials funded through VA/DOD and other sources and has been training providers in PTSD treatment since 2000 including working with a team to establish a PTSD training network in Japan following the triple disaster in 2011. She has published scholarly articles, chapters, and books on anxiety disorders and posttraumatic stress disorder (PTSD) focusing on neurobiology and factors involved in the development, maintenance, and treatment of anxiety disorders, psychosocial factors in medical settings, and the relation between physical health and anxiety. She is an author of the second edition of the Prolonged Exposure manual and patient workbook as well as the PE for Intensive outpatient programs manuals.  Dr. Rauch has been involved in the modification and adaptation of proven psychotherapeutic interventions for anxiety disorders for various populations and settings, including primary care. She is a fellow of the Association of Behavioral and Cognitive Therapy (ABCT), was granted membership in the American College of Neuropsychopharmacology, and serves as a member of the Board of Directors and Scientific Council of the Anxiety and Depression Association of America.  

 Dr. Rauch and ADAA

"I joined ADAA in my first year as a professional psychologist as the organization was a good fit for my budding academic medical career. ADAA was the exceptional organization that included mental health professional from all types of practice as well as patients and their families.  The goal to push science, practice, and recovery was wholly in line with my perspective.  The Scientific preconference had a very good reputation for providing the highest quality of scientific research on anxiety disorders and the quality spilled over into the conference.

The multidisciplinary atmosphere of the organization that provides space and value to all scientific practice to support those suffering with mental health issues.

ADAA helps me to get out of my comfort zone to see what is happening in the larger mental health field. As a clinical researcher, I can easily get stuck in my perspective and people who practice in the same way as me. ADAA gives me connections to very different type of providers and practices while staying evidence based.”

Carmen McLean, PhD

Carmen McLean PhD

Carmen McLean, PhD, is a clinical psychologist at the Dissemination and Training Division of the National Center for PTSD at the Palo Alto VA and a Clinical Associate Professor (Affiliate) in the Department of Psychiatry and Behavioral Sciences at Stanford University. Her research examines ways to increase the reach of exposure therapies for PTSD by addressing therapist and clinic-level implementation barriers and testing eHealth and mHealth interventions, with the overall goal of helping more individuals with PTSD benefit from evidence-based treatment.

Retraining the Brain

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Retraining the Brain Sheila Rauch and Carmen McLean

The human brain is powerful, flexible, fragile, and yet strong. Within its many wrinkles and structures lies the key to human understanding. The past 30 years of research has seen vast leaps in our understanding of how the brain works in function and dysfunction. This remains true despite the fact that we are still in the infancy of neuroscience as a field.  We expect the next 30 years will show exponential advances over what we currently know about how the brain works.  As neuroscience has advanced, the specialization required to examine how specific structures work as well as how neurochemicals impact function has led to silos within neuroscience. Often those doing research on one structure or neurochemical may have little contact or discussion with others even though all of the systems and functions of the brain interact and often regulate each other. In addition to these silos within neuroscience, the silo of neuroscience is significant and makes it difficult for those without neuroscience training to understand and contribute to neuroscience research.  For most mental health providers and even mental health treatment researchers, it is difficult to stay abreast of the latest neuroscience techniques and findings and often difficult to see how that research applies to their work.  In addition, ever increasing time constraints on providers makes it difficult to even have time to ponder neuroscience and how it may be relevant to helping their patients. 

The past 30 years has also seen significant advances in PTSD treatment leading to patients now having multiple options for effective PTSD treatment that include several psychotherapies and medications. Exposure therapy is a first line treatment for PTSD that involves retraining the brain and turning back on the stalled mechanisms of natural recovery.  However, not all patients benefit from exposure therapy. The next 30 years of PTSD treatment research will prioritize finding ways to identify those who are less likely to remit with treatment, to optimize outcomes, and to increase treatment access and retention. To really move the field forward, these goals require a better understanding of HOW effective PTSD treatments work in the body and especially in the brain.  We need to learn HOW we are retraining the brain with effective treatment.  Recent work that brings together treatment researchers and methods with neuroscience research is beginning to merge neuroscience with clinical science and practice. Each of these groups has a unique and important perspective on PTSD treatment and each can inform the next steps in advancing the care of those suffering with PTSD. As we learn HOW treatment works we are able to then make changes to make it work more effectively, efficiently, and even retain people in treatment who may leave due to slow or low response. The challenge lies in communication as each field has its own language and level of examination for similar and even overlapping constructs.  As an example, what a neuroscientist describes as a blunted cortisol response, an treatment researcher may describe as a non-responder, and a clinician may describe as flat affect or an underengagement in therapy.  Without a translational guide, it is difficult if not impossible for these professionals to see the parallels in the phenomena they examine and thus impossible for these fields to fully benefit from the advances of science.  As psychologists who have been in ALL of these roles, we wanted to provide a step towards more understanding and cross pollination of PTSD treatment research and clinical work through writing an applied neuroscience primer for PTSD treatment providers and PTSD researchers to quickly get up to speed and into the current thriving discussions of neuroscientists in PTSD. Our book Retraining the Brain: Applied Neuroscience in Exposure Therapy for PTSD lays out basic neuroscience methods and then applies the latest research to Prolonged Exposure Therapy for PTSD to open communication between clinicians, treatment researchers, and neuroscientists and promises to increase understanding and open a new collaborative potential to advance science. We hope that clinicians, neuroscientists, training directors, clinical trials researchers, and others find this book a useful tool to bridge neuroscience and clinical applied research.

Sheila Rauch, PhD, ABPP - ADAA Board Member

Member Since 2002

Sheila A.M. Rauch, Ph.D., ABPP, led design and now serves as Deputy Director of the Emory Healthcare Veterans Program and Director of Mental Health Research and Program Evaluation at the VA Atlanta Healthcare System. Dr. Rauch has been developing programs, conducting research and providing PTSD and Anxiety Disorders treatment for over 20 years. Her research focuses on examination of mechanisms involved in the development and treatment of PTSD and improving access to effective interventions. She has led several PTSD treatment outcome and mechanisms trials funded through VA/DOD and other sources and has been training providers in PTSD treatment since 2000 including working with a team to establish a PTSD training network in Japan following the triple disaster in 2011. She has published scholarly articles, chapters, and books on anxiety disorders and posttraumatic stress disorder (PTSD) focusing on neurobiology and factors involved in the development, maintenance, and treatment of anxiety disorders, psychosocial factors in medical settings, and the relation between physical health and anxiety. She is an author of the second edition of the Prolonged Exposure manual and patient workbook as well as the PE for Intensive outpatient programs manuals.  Dr. Rauch has been involved in the modification and adaptation of proven psychotherapeutic interventions for anxiety disorders for various populations and settings, including primary care. She is a fellow of the Association of Behavioral and Cognitive Therapy (ABCT), was granted membership in the American College of Neuropsychopharmacology, and serves as a member of the Board of Directors and Scientific Council of the Anxiety and Depression Association of America.  

 Dr. Rauch and ADAA

"I joined ADAA in my first year as a professional psychologist as the organization was a good fit for my budding academic medical career. ADAA was the exceptional organization that included mental health professional from all types of practice as well as patients and their families.  The goal to push science, practice, and recovery was wholly in line with my perspective.  The Scientific preconference had a very good reputation for providing the highest quality of scientific research on anxiety disorders and the quality spilled over into the conference.

The multidisciplinary atmosphere of the organization that provides space and value to all scientific practice to support those suffering with mental health issues.

ADAA helps me to get out of my comfort zone to see what is happening in the larger mental health field. As a clinical researcher, I can easily get stuck in my perspective and people who practice in the same way as me. ADAA gives me connections to very different type of providers and practices while staying evidence based.”

Carmen McLean, PhD

Carmen McLean PhD

Carmen McLean, PhD, is a clinical psychologist at the Dissemination and Training Division of the National Center for PTSD at the Palo Alto VA and a Clinical Associate Professor (Affiliate) in the Department of Psychiatry and Behavioral Sciences at Stanford University. Her research examines ways to increase the reach of exposure therapies for PTSD by addressing therapist and clinic-level implementation barriers and testing eHealth and mHealth interventions, with the overall goal of helping more individuals with PTSD benefit from evidence-based treatment.

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