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Home Base has been offering outpatient programs for 10 years and intensive programs for the last five, during which time they have learned two main lessons. The first is the importance of designing individual treatment plans for each person based on their biomarkers of injury, symptoms, and needs. Secondly, they learned the importance of follow through post-program—whether helping a service member or veteran learn the tools for self-management when ready or educating local practitioners to better help the military population with TBI and/or PTSD.
Researchers and doctors are learning more about how blast injuries, especially if repetitive and sustained close together, can affect the brain far more significantly than a singular blow to the head as from football, boxing, or a car crash. When treating veterans and service members, clinicians in the Home Base program start by taking an in-depth TBI history starting from childhood to the present. The more they understand the mechanism, frequency, and interval between any sustained injuries, the more pointed their treatment can be.
Oftentimes, a family member is the first to recognize symptoms of TBI and/or PTSD in their loved one who has returned from military service. At the Home Base program, veterans and service members are accompanied by a family member for part of the two-week intensive so upon returning home, the family knows better how to help their loved one understand their symptoms and aid with and ongoing treatments, interventions, medications, and general support.
TBI is a multi-faceted injury that can present physically through headaches, balance, hearing, or vision problems; psychologically through depression or post-traumatic stress; cognitively through memory and attention issues; or all or a combination of these “buckets.” Home Base is a two-week intensive program for veterans and service members that serves as part of their journey to recovery. After the two weeks, case managers help their clients set up the necessary care and services they need in their community and follow their progress.
Dr. Iaccarino shares how suffering a spine injury as a teenager sparked her passion for helping others with brain injury using neurological rehabilitation and recovery, especially veterans and military service members.
After sustaining a spinal injury as a teenager, Dr. Mary Alexis Iaccarino changed the trajectory of her future. She spent months and years in rehab for her neurological injury then went on to become a physiatrist who specializes in treating and rehabilitating people with the most clinically complex cases of sports concussion, traumatic brain injury, and repetitive head trauma. When she treats veterans and service members, she harkens back to her own experiences, encouraging them toward second careers and full lives even with a TBI.
In our country—and around the world—we are witnessing a rise in suicide, drug dependency, and poor access to physical and mental health services. Programs like Wounded Warrior Project feel it is their responsibility to translate their best practices offered to veterans and service members for treatment and rehabilitation for these conditions to the entire country and world of civilians.
Recently, Wounded Warrior Project funded a study with the Rand Corporation on the need to treat substance use disorder along with treating traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD). The often co-occurring conditions must be treated simultaneously to be as effective as possible.
Because Wounded Warrior Project works with many vets who have TBI and/or PTSD, staff hear many misconceptions. One misconception is that there are no treatments for TBI and PTSD. Not true. There are gold-standard treatments to heal people with PTSD and there are very effective rehab programs for people with TBI. Also, people need to remember that both of these conditions are often invisible wounds and can affect anyone—male, female, young, old, and so on.
A traumatic brain injury or repeated brain traumas can sometimes lead to chronic traumatic encephalopathy, Parkinson’s, multiple sclerosis, astrogliosis, or other neurogenerative conditions. Since researchers are still learning about the progression of these diseases, which can stem from repeated TBIs, providers are currently trying to plan and address how to change their model of care to best help veterans and their families in the long term.
Service members and veterans feel a deep connection with each other and their families. Through Wounded Warrior Project’s various programs—in-person and/or online—veterans can come together, empower each other, and once home, support the greater good of their communities.
John, an Air force veteran, who sustained a TBI has benefitted greatly from almost all of the programs offered through Wounded Warrior Project. With help from community support specialists, life skills coaches, and other alternative treatments, John—and his wife—have turned some of their challenges into advantages and are now giving back to their community.
Wounded Warrior Project’s Independence Program case managers understand that when a service member has a TBI or other physical or mental health issues, the whole family is affected—in the short- and long-term. WWP case managers get to know their families intimately, checking on them weekly and helping them find the services and resources they need. They are always available to help families navigate through these sometimes-complex situations.
The core services of Wounded Warrior Project’s Independence Program include case management, resource management, care coordination, home health aide, alternative therapies, and more, with the primary goal of helping service members and their families rebuild a normal routine, plan for and succeed in the long-term, independently. But the program is always there as a safety net if new challenges arise.
Wounded Warrior Project’s Independence Program does not have a protocol to work with service members and their families when they transition home from a clinical facility, but they do have a highly successful formula for independent programing that caters to the individual needs of their clients whether those needs arise from the vet’s neurological trauma or from emotional or psychological challenges that result from that trauma.
Wounded Warrior Project wants vets to return home and thrive in their communities. With that in mind, WWP offers a continuum of supports and services for vets to address mental health, brain health, and physical health well-being. Acting collaboratively, WWP staff work to find the best program or combination of programs to fit an individual’s needs.
There is some good research showing that the use of psychedelics may be beneficial in combination with psychotherapy for treating PSTD, but more research and more comprehensive data are needed before fully implementing them as a viable option.
Treating PTSD in post-9/11 and other veterans is best undertaken with experts in prolonged exposure and cognitive processing therapy. Experts in these therapies can be found in person or via telehealth through the Warrior Care Networks. WCN providers also share their treatment models with primary care doctors and buddy system programs to expand their reach.
Two of the most researched and effective treatments for PTSD are prolonged exposure and cognitive processing therapy. The first involves approaching instead of avoiding traumatic memories, the second working on changing thought patterns to reduce the impact of the trauma. With the help of an experienced provider, people can be successfully treated for PTSD.
Emory Healthcare Veterans Program’s two-week PTDS Treatment intensive for post-9.11 vets is a convenient and effective means for people to get needed treatment for PTSD, TBI, depression, chronic pain, and substance abuse from home. The results are the same whether accessing care via telehealth or on site.
Experiencing PTSD and chronic pain simultaneously can sometimes lead to suicidal thoughts. But with guidance from family and friends to find the right resources and professionals, people can access highly effective combined treatments that help them return to a full life—physically and emotionally.
Veteran Morgan Luttrell wasn't interested in focusing his studies on brain injuries, but he quickly became a resource for those who had questions. Soon he was helping others by sharing his experiences and connections.
Veteran Morgan Luttrell traveled the country looking for help after the injuries to his brain and body. He found the most with Dr. James Kelly at the National Intrepid Center of Excellence (NICoE). They provided him with a whole picture and a plan.