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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.

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.

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.

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.

Often feelings of lost connection with family members—whether with a spouse, children, parents, or siblings—is what finally catalyzes a veteran or service member to seek treatment for TBI and/or PTSD. For example, a Special Ops veteran who had deployed 10 times during a 35-year military career finally sought treatment through the Home Base program because his child told his wife that he was afraid of him. He did not want the effects of TBI and/or PTSD to create irreparable damage to his whole, multigenerational family.

Dr. Mary Alexis Iaccarino tells the story of a service member who sent her team a note of thanks along with a photo of himself attending his daughter’s graduation. Before attending the Home Base program as well as a special brain health and trauma program for Special Operations Forces, he could never have imagined being in a crowd filled with noises and lights. For him, attending the graduation was a huge win; because of treatment he was able to participate in a big family moment.

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.

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.

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.

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.

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.

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.