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If I could tell civilian providers working with veterans and service members with PTSD and other mental health challenges one thing, it would be that this population includes some of the most resilient people on the planet. I think we do a disservice to them by fragilizing them, treating them as if going through these intense therapies—cognitive behavioral therapy, prolonged exposure therapy, and discussions around moral injury and military sexual trauma among others—will break them. On the contrary, during Road Home's two-week intensive program, I have seen undue strength and resiliency demonstrated, which often lead to significant healing.
For many veterans and service members returning from deployment, not having their "team," their battle buddies around is very difficult. Everything seems to be about the individual. Capitalizing on this team unity mentality, providers at the Road Home Program understand that more healing will happen when people are working on individualized therapies as well as group therapies and activities. Once again, they have each other's backs.
A two-week program for veterans and services members who have PTSD and other mental health issues, Rush Medical Center's Road Home is intense, fast, and efficient. Through evidence-based studies and experience, providers have found that this two-week intensive is far more effective than traditional therapy to help with symptom remission and increases in resilience.
The use of psychedelics for PTSD is an example of a therapeutic intervention that the medical field has, until lately, put to the side. There was no funding, nor research on the topic; now, medical professionals and researchers are looking into its potential use for PTSD and believe that, with specific focus, it may have a great benefit.
For tens of thousands of years, there has been a deep symbiosis between humans and dogs. With their superior senses—far more attuned than those of humans—dogs have come to discern human emotions, something that benefits both species. Research in the last several decades has also shown that service dogs that have been exceptionally trained and certified can help people the symptoms of PTSD like nightmares, anxiety, and sleep and behavioral disturbances.
Treating service members and veterans with TBI and PTSD often includes complex and unique interventions and treatments. Based on their evidence-based guidelines and experiences working with thousands of people in their two-week immersive program, Home Base also focuses intentionally and systematically on assessing what the population needs once they leave the program and return to their communities. The more Home Base can help connect their participants with clusters of experts in their areas, the more long-term healing will occur.
The biggest and most nefarious misconception about TBI is that it doesn’t get better. That is simply not true. The vast majority of people with TBI do well over time and can be effectively treated to live functional and fulfilling lives. However, that does not counter the risk of behavioral, medical, and cognitive problems in the long term. With more research and experience, experts in the field are focusing on learning more to mitigate risk and improve the outcome of those with TBI in both the short and long term.
Does success translate into riding a horse again, returning to your pre-military job as an accountant, or coaching your kid’s Little League team? Staff at the Home Base Program understand that what success looks like for one military member with TBI and/or PTSD may look 180-degrees different from that of another. Using evidence-based guidelines to drive their therapeutic regimens as well as applying lessons learned from helping thousands of people in the program, Home Base providers are not only fine-tuning what they do each day but also learning and creating the next generation of effective therapies.
Staff at Home Base are awed—daily, hourly—by the resilience, determination, and dedication of the veterans and service members with whom they work during the two-week immersion program. Dr. Zafonte recalls one Special Forces member who was injured multiple times but whose focus, invariably and unblinkingly, was to restore himself so as to return to theater to continue to serve. Military members like this man exemplify a dedication to protect our country; something all of us should take time to better understand and appreciate.
Home Base’s two weeks of assessments and individualized therapies focused on treating veterans and services members with TBI and PTSD seems to be the “sweet spot” of time for this kind of immersive program. Staff in the program have seen lives changed, lives saved. They understand that the veteran experience is a unique one, hard for civilians to fully comprehend. Providing these men and women with the tailored interventions and therapies they need to enhance function in their day-to-day life is often as important as the bonding aspect of being with others who have had and continue to have similar experiences, challenges, and forward steps.
One of the most powerful aspects of the Home Base Program is the way it helps veterans and service members come together again with those who may have had similar experiences in combat and now back at home with issues around TBI and PTSD. Along with the comprehensive individualized treatment plans for each person, the program includes group therapies and events, which play a large role in the healing process.
The Home Base program, which includes comprehensive assessments and a two-week immersion into therapies and treatments for TBI, PTSD, and other conditions, is created anew for each veteran or service member who joins. Whether engaging in physical or cognitive therapeutic interventions, learning how better to communicate with family and friends, or delving into art therapies, each individual becomes part of a strong and supportive community of people who understand their experiences, though everyone’s experiences and issues are unique and treated as such.
Home Base, a free Red Sox Foundation and Mass General Hospital program, started small, but then and now—as it has grown to help 1,000s of veterans and service members nationwide—it remains a passion for many. The program focuses on treating the invisible wounds of war like TBI and PTSD. With evidence-based treatments in all domains like behavioral therapy, physical therapy, health and wellness, and medications, providers help these warriors with issues that run the gamut from sleep apnea and cognitive function to depression and physical pain.
The jury is still out on the exact ways that repeated blast injuries affect the brain. Some believe that the blast waves travel through the organs, producing a change in the gray-white matter of the brain. Others believe that blast-related injuries produce a unique pathology while others still think that the pathological signals from these injuries result in behavioral disturbance. But all researchers seem to agree that repeated blast-related injuries affect a person’s brain in the short-term as well as in the long-term with the risk of neurodegenerative disease.
For many service members and veterans, traumatic brain injury and PTSD often go hand in hand, with some of the symptoms of these conditions being co-morbid. By using evidence-based treatments, providers work with their patients with the goal of getting them as symptomless as possible.
A family member or support person at home plays a key role as part of the treatment plan for a service member or veteran. An adjunct in their loved one’s care, the family member collaborates with the team of providers to help their loved one follow through with appointments, medications, and health regimens. They often serve as the more impartial eyes and ears to their loved one’s challenges and improvements.
Changes don’t happen 0-60 mph, rather they occur incrementally. Providers know that barriers can impede improvement to healing, but by setting a series of step-by-step goals—whether treatments for better sleep, pain relief, or relationship strategies— service members and veterans can see improvements to their physical, behavioral, and emotional issues and build on them from there.
Like so many other brain injury survivors, I appear to be okay. And while many know of my past history, many others think I am well beyond my brain injury challenges and struggles. Why wouldn’t they?
I have a streaming service subscription. Unlike the popular streaming services so many of us are familiar with, the rules for this service are different: The terms of agreement are lifelong, and there is no opportunity to cancel. And this streaming service allows new content based entirely on my previous viewing habits.
The Road Home Program has had great success treating both female and male survivors of military sexual trauma. Through cognitive processing therapy and other therapies like mindfulness and therapeutic arts—working with providers and alongside peers who have had similar experiences—survivors of military sexual trauma can transform their feelings of powerlessness into a stronger sense of self.
There is great hope and are effective cures to treat people who experience symptoms from trauma or PTSD. Often people have the misperception that PTSD is a chronic, life-time condition. Not so; with treatment, most people can be cured or helped to manage their symptoms so as to return to a productive life.
Part of Rush University Medical Center’s efforts around helping people with trauma and/or PTSD is working with the community—whether screening children more effectively during pediatric visits, working with families, or advising schools. Ongoing adverse events in inner city communities can cause young children, adolescents, and adults to experience trauma and PTSD, but these issues are treatable with professional interventions.
Telling your loved one with PTSD that you cherish them, you care about them, and that you will help them if they will let you is a powerful first step toward getting that person needed treatment. You can’t take on someone else’s suffering—unproductive, anyway—but you can steer them toward the resources and providers who can help them.
Two-week intensive outpatient programs that implement a comprehensive, holistic approach to treatment, The Road Home Program includes two treatment arms for veterans and their families—one for veterans who experience battlefield PTSD, the other for survivors of military sexual trauma. Their data reveal high success rates during the program and in the long-term, post-program.
At Rush’s Road Home Program, providers use evidence-based cognitive processing therapies and other data-driven therapies like mindfulness to treat veterans with post-traumatic stress disorder (PTSD). This intensive treatment model effects far more cures for PTSD in veterans than the traditional, one-on-one, long-term psychotherapy model. Rush is working to offer their therapy model to other populations who may experience PTSD like police, firefighters, first responders, and emergency department staff.