Ross Zafonte, DO: Barriers for Service Members Getting PTSD and/or TBI Treatment and Sticking to It


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.

Dr. Ross Zafonte is the Chief of Traumatic Brain Injury for Home Base, part of the Wounded Warrior Project's Warrior Care Network.

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The barriers to people with brain injury or PTSD getting treatment are multiple. One is developing an affinity or a stickiness with their providers. Two, really having access, can they get there? Can they get to therapy, and can they adhere to it? Adhere to their pharmacotherapy, if necessary, adhere to their behavioral therapy, most importantly, adhere to their physical therapy or other forms of intervention. Can they stick it out and what are the kinds of things that we can do to make them most adherent? among the things we’ve learned for people with brain injury or PTSD to make them so-called “sticky” with a treatment plan, is really incrementalizing goals. Rather than trying to get to a touchdown or goal line right away, we try to have everybody see a series of steps, a series of first downs that are a path, a path to victory. the idea for, in so many ways, is to create a program that demonstrates an incremental improvement. That’s why measures are so important, that’s why goals are so important. To expect anyone to go from zero to 60 right away is unreasonable. But to really look at “what are the most meaningful things to a person?” Perhaps their relationship with their spouse, perhaps the ability to be pain-free or pain functional. The ability to sleep better. Those are the kinds of things that we look for incremental improvement and that we can show them in some form of a hard measure or metric. 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 October 5, 2021. Reviewed October 5, 2021.

About the author: Ross D. Zafonte, DO

Dr. Ross Zafonte is the Clinical and Research Leader for Traumatic Brain Injury at the Red Sox Foundation and Massachusetts General Hospital Home Base Program. He is the Earle P. and Ida S. Charlton Chairman of the Department of Physical Medicine and Rehabilitation at Harvard Medical School, vice president of Medical Affairs at Spaulding Rehabilitation Hospital, and Chief of Physical Medicine and Rehabilitation at MGH.

Headshot of Dr. Ross D. Zafonte