Healing the warrior: admission of two American Indian war-veteran cohort groups to a specialized inpatient PTSD unit.

The American Lake VA Post-Traumatic Stress Disorder (PTSD) Treatment Program provides intensive inpatient treatment for war-related PTSD and associated conditions. As part of a substantial outreach effort to American Indians (AI) in the Northwest U.S., the program significantly modified its admission criteria and treatment to be more clinically and culturally relevant. An all-AI cohort, and then a group that was 50% AI, were admitted. Highlighted are lessons learned regarding: treating "traditional" versus more "assimilated" AI veterans; culture-specific additions of building and utilizing a sweatlodge on the hospital grounds, hiring an AI spiritual leader as a clinical advisor, and promoting attendance at weekend Pow-Wows; the relevance of the "regular" treatment components; and the need for regular debriefings about counter-transference dynamics among staff.