Mary Alexis Iaccarino, MD: Importance of Individualized Treatment for Veterans with TBI

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.

Dr. Mary Alexis Iaccarino is director, Clinical TBI and Brain Health Services, Home Base.

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Some of the lessons we’ve learned after running outpatient TBI care for ten years now at Home Base, plus, and then intensive treatment programs for the last five years, is that every individual is different. You can’t create cookie cutter programs for just predetermined recipes that are going to get everyone better. So particularly in TBI care, we’ve really looked at designing more individualized treatment plans and I think that that’s something that has really helped us to focus in on the individual person’s needs. That comes from doing really thorough assessments of the individual, looking uniquely at what some of the biomarkers of injury are for them, and then targeting those things individually. So I think that’s one of the biggest things we’ve learned. And then I think one of the second things that we’ve learned is that we need really good follow-through. Not everything can be fixed or fully better in a week or two. For many people this is going to be something that’s going to have to get managed. Right? Think of it like your blood pressure, or you know, that old knee injury. We’re going to have to manage this over time. We’re going to have to give people support after they leave the program, but also give them the tools to self-manage. And that’s actually a big part of what we do. Home Base has actually really leaned forward and developed a training institute with the goals of educating local civilian providers on how to address the needs of military service members with post-traumatic stress. And soon we’ll be rolling out training for TBI so that we can actually get expert care to patients in their home community once they leave Home Base. BrainLine is powered in part by Wounded Warrior Project to honor and empower post-9/11 injured service members, veterans, and their families.

Posted on BrainLine September 28, 2021. Reviewed September 28, 2021.

About the author: Mary Alexis Iaccarino, MD

Mary Alexis Iaccarino, MD, is a board-certified physiatrist with sub-specialty training in brain injury medicine. Her clinical and research areas of interest include diagnostic and treatment strategies in mild traumatic brain injury including blast and sport-related concussion. Dr. Iaccarino joined the Home Base team in 2016 as a brain injury physiatrist for the Intensive Clinical Program (ICP) and outpatient TBI program. Her goal is to provide comprehensive, evidenced-based brain injury care to veterans through multidisciplinary collaboration with psychology, neuropsychology, physical therapy, psychiatry, and other specialists. She specializes in the treatment of physical, cognitive, and behavioral deficits that occur after brain injury including headaches, pain, dizziness and vision symptoms, sleep difficulties, fatigue, concentration, and memory problems.

Headshot of Dr. Mary Alexis Iaccarino in a salmon button-down shirt