20110510 PTSD Ft Bliss RRCENTER Presentation

8/3/2019 20110510 PTSD Ft Bliss RRCENTER Presentation

1/49

THETHEFORT BLISSFORT BLISS

RESTORATIONRESTORATION

& RESILIENCE& RESILIENCECENTERCENTER


2/49

Mission StatementMission Statement

TheThe FFortort BBlissliss RRestoration andestoration and RResilienceesilience CCenterenterrestores optimal functioning and battlerestores optimal functioning and battle--readinessreadiness

toto neurophysiologicallyneurophysiologically, psychologically, psychologically

and spiritually challengedand spiritually challenged

postpost--deployment Soldiers and their familiesdeployment Soldiers and their families

using integrated stateusing integrated state--ofof--thethe--art treatmentart treatment

to stimulate maximum resilience.to stimulate maximum resilience.


3/49

Program ImpetusProgram Impetus

Soldiers being treated atSoldiers being treated at CMHSCMHS

forfor PTSDPTSD

whowho

did not want to be medically dischargeddid not want to be medically discharged

Unit Pressure: 3 monthsUnit Pressure: 3 months FFDFFD oror MEBMEB

MEBMEB statement:statement: This Soldiers has receivedThis Soldiers has receivedmaximum benefit from both inpatient andmaximum benefit from both inpatient andoutpatient careoutpatient care


4/49

R&RR&R Center Core TheoryCenter Core TheoryPTSDPTSD

is a complex condition involving:is a complex condition involving:

Damage/dysfunction in several structures inDamage/dysfunction in several structures inthe brainthe brain

DysregulationDysregulation of central/peripheral nervousof central/peripheral nervoussystemsystemComplex cognitive & emotional dysfunctionComplex cognitive & emotional dysfunctionSocial/interpersonalSocial/interpersonal maladaptationmaladaptation

Spiritual disequilibriumSpiritual disequilibrium


5/49

Treatment TheoryTreatment Theory

Adequate treatment must be:Adequate treatment must be:

ComprehensiveComprehensive, addressing all aspects of the, addressing all aspects of theconditioncondition

IntensiveIntensive, to produce profound rehabilitation, to produce profound rehabilitationof mind, body and soulof mind, body and soul

Long enoughLong enough to achieve lasting changeto achieve lasting change


6/49

RibbonRibbon--CuttingCutting 11 July 200711 July 2007


7/49

VIP VisitsVIP Visits

Hon. Robert Gates, Secretary of DefenseHon. Robert Gates, Secretary of Defense

Hon. PeteHon. Pete GerenGeren, Secretary of the Army, Secretary of the Army

General George Casey, Chief of Staff & SpouseGeneral George Casey, Chief of Staff & Spouse

General Richard Cody, Vice Chief of Staff & SpouseGeneral Richard Cody, Vice Chief of Staff & Spouse

CSMCSM

WilliamWilliam

GaineyGainey

,,

SEACSEAC

, Joint Chiefs of Staff, Joint Chiefs of Staff

Congressman Duncan Hunter & SpouseCongressman Duncan Hunter & Spouse

Congressman John Murtha & SpouseCongressman John Murtha & Spouse

Congressman Silvestre Reyes & SpouseCongressman Silvestre Reyes & SpouseMembers of the House ArmedMembers of the House Armed SvcsSvcs. Comm.. Comm.

Many, many general grade officersMany, many general grade officers

More than 50 tours in 10 monthsMore than 50 tours in 10 months


8/49

The FacilityThe Facility

19401940s barrackss barracks

6,000 square feet6,000 square feetRehabbed for $549,000Rehabbed for $549,000

Equipped for $170,000Equipped for $170,000


9/49

Main Features of BuildingMain Features of Building

AnAn exclusiveexclusive

place for postplace for post--deploymentdeployment

Soldiers & their familiesSoldiers & their families

NonNon--medical lodgemedical lodge--likelike ddcorcor

AA milieumilieu, not a clinic for appointments, not a clinic for appointments

Long hoursLong hours

Quiet space plus noisy spaceQuiet space plus noisy space

Rooms for Alternative MedicineRooms for Alternative Medicine


10/49

12 Therapy Rooms12 Therapy Rooms

1 Biofeedback1 Biofeedback

1 Testing/Cog Rehab1 Testing/Cog Rehab

2 Family Therapy2 Family Therapy

9 Individual/Couple Therapy9 Individual/Couple Therapy


11/49

3 Alternative Medicine Rooms3 Alternative Medicine Rooms

1 Acupuncture1 Acupuncture

2 Medical Massage Therapy/Hot Stone Therapy/Reiki2 Medical Massage Therapy/Hot Stone Therapy/Reiki


12/49

Meditation RoomMeditation Room


13/49

WarriorWarriorLoungeLounge


14/49

Conference/GroupConference/Group RoomRoom


15/49

Movement Therapy RoomMovement Therapy Room((SprungSprung floor)floor)


16/49

RecRec RoomRoomWideWide--screen TV with cable, beanbag chairs, sofascreen TV with cable, beanbag chairs, sofa

Computers for games/eComputers for games/e--mail accessmail accessWiiWii

PlaystationPlaystation

Foosball TableFoosball Table

Game TableGame Table

DartboardDartboardUniversal Gym/MirrorUniversal Gym/Mirror

RecRec RoomRoom


17/49

ProgramsPrograms

Warrior Resilience ProgramWarrior Resilience Program

Family Resilience ProgramFamily Resilience Program


18/49

Warrior Resilience ProgramWarrior Resilience Program

Duration of CareDuration of Care

6 months optimal, individualized program (no phases)6 months optimal, individualized program (no phases)

4 weeks of Aftercare4 weeks of Aftercare

All participants assigned to the Warrior Transition Unit ofAll participants assigned to the Warrior Transition Unit of WBAMCWBAMC

Billeted withBilleted with WTUWTU

unless living off postunless living off post

Anticipated number of Soldiers to be treated in Year 1:Anticipated number of Soldiers to be treated in Year 1: 100100


19/49

Modalities of TreatmentModalities of Treatment

Psychiatric CarePsychiatric Care (Medical evaluation, medication management)(Medical evaluation, medication management)

PsychotherapyPsychotherapy

(Individual &(Individual & Group)(EMDRGroup)(EMDR, Hypnotherapy, psychodynamic,, Hypnotherapy, psychodynamic,

Prolonged Exposure,,Prolonged Exposure,, Grief workGrief work,, CPTCPT,, Life CoachingLife Coaching))

BiofeedbackBiofeedback

((EEGEEG NeurofeedbackNeurofeedback,,

Quantitative EEG,Quantitative EEG, CapnographyCapnography, Breath, Breath

Coaching,Coaching,

AudioAudio--Visual Entrainment (AVE),Visual Entrainment (AVE),

FreezeFramerFreezeFramer,, Wild DivineWild Divine, Stress, Stress

EraserEraser,,

emWaveemWave

andand RESPeRATERESPeRATE))

Lifestyle PracticesLifestyle Practices

(Nutrition, Sleep Hygiene, Alcohol/Drug, Finance, Couple(Nutrition, Sleep Hygiene, Alcohol/Drug, Finance, Couple

Dynamics,Dynamics, PTSDPTSD

101, Panic disorder, Psychotropic Meds)101, Panic disorder, Psychotropic Meds)

Alternative Medical InterventionsAlternative Medical Interventions

(Acupuncture, Chiropractic, Reiki, Therapeutic(Acupuncture, Chiropractic, Reiki, Therapeutic

Massage, Cranial Electro Stimulation, Hot Stone Therapy, NaturopMassage, Cranial Electro Stimulation, Hot Stone Therapy, Naturopathy, Meridianathy, Meridian

Flexibility SystemFlexibility System, Reflexology), Reflexology)

Expressive TherapiesExpressive Therapies

(Art Therapy, Drum Therapy)(Art Therapy, Drum Therapy)

MindMind--Body TherapiesBody Therapies

((QiQi

Gong,Gong, TTaiai

Chi, Yoga, YogaChi, Yoga, Yoga NidraNidra, Physical Therapy,, Physical Therapy,

AryuvedicAryuvedic

Breathing, Occupational Therapy)Breathing, Occupational Therapy)

Recreational TherapiesRecreational Therapies

(Water Polo, Therapeutic Outings)(Water Polo, Therapeutic Outings)

Meditative/Spiritual InterventionsMeditative/Spiritual Interventions

(Meditation, Progressive Muscle Relaxation, Sweat(Meditation, Progressive Muscle Relaxation, Sweat

Lodge, Warrior Spirituality Groups, Spiritual Counseling)Lodge, Warrior Spirituality Groups, Spiritual Counseling)


20/49

WE NEED TO TREATWE NEED TO TREATTHE WHOLE SOLDIERTHE WHOLE SOLDIER

NEED FOR NEW APPROACHNEED FOR NEW APPROACH

Limitations of psychiatric lens lead to underLimitations of psychiatric lens lead to under-- treatment or nontreatment or non--treatment of:treatment of:

Swelling ofSwelling ofamygdalaamygdala

andand overactivationoveractivation

ofofHPAHPA

AxisAxis

Damage to hippocampusDamage to hippocampus

Disruption of family and social networksDisruption of family and social networks

Profound spiritual disequilibriumProfound spiritual disequilibrium

Core Treatment Principle:Core Treatment Principle:


21/49

5HTT GENE5HTT GENE

FUNCTION:FUNCTION: REGULATESREGULATES

SEROTONINSEROTONIN

SEROTONIN:SEROTONIN: INVOLVEDINVOLVED

IN DEPRESSION ANDIN DEPRESSION AND

ANXIETYANXIETY

THREE POSSIBILITIES:THREE POSSIBILITIES:DOUBLE SHORT (SS)DOUBLE SHORT (SS)

DOUBLE LONG (LL)DOUBLE LONG (LL)

MIXED (LS)MIXED (LS)

PEOPLE WITHPEOPLE WITH SSSS HAVEHAVE

66--88 TIMESTIMES THE CHANCETHE CHANCE

OF GETTINGOF GETTING PTSDPTSD THANTHAN

PEOPLEPEOPLE WITHWITH LLLLC O M B A T T R A U M A

POSTTRAUMATC

POSTTRAUMATCSTRESSDSORDER

STRESSDSORDER


22/49

Cerebral Cortex

PrefrontalLobe


23/49

Treatment Framework/Treatment Framework/ InterventionIntervention Tracks'Tracks'

Agoraphobia/Claustrophobia ReductionAgoraphobia/Claustrophobia Reduction

Cognitive Error RemediationCognitive Error Remediation

Memory Function RehabilitationMemory Function Rehabilitation

Emotional/Grief WorkEmotional/Grief Work

Sleep ImprovementSleep Improvement

Military ReintegrationMilitary Reintegration

Physical Arousal ReductionPhysical Arousal Reduction

ReRe--Socialization/Family ReintegrationSocialization/Family Reintegration

Spiritual HealingSpiritual Healing


24/49

Intervention DetailIntervention Detail

AGORAPHOBIA/CLAUSTROPHOBIA REDUCTIONAGORAPHOBIA/CLAUSTROPHOBIA REDUCTION

Goal:Goal:

Increase Soldier's tolerance for public places, crowds,Increase Soldier's tolerance for public places, crowds,

enclosed areasenclosed areas

Interventions:Interventions:

Therapeutic outings to challenging publicTherapeutic outings to challenging public

places (e.g., malls, bowling alley, Carlsbad Caverns) coupledplaces (e.g., malls, bowling alley, Carlsbad Caverns) coupledwith relaxation (arousal reduction) toolswith relaxation (arousal reduction) tools


25/49


COGNITIVE ERROR REMEDIATIONCOGNITIVE ERROR REMEDIATION

Goal:Goal:

Reduce Soldier's cognitive distortions and errors relatedReduce Soldier's cognitive distortions and errors related

to combat experienceto combat experience

Intervention(sIntervention(s):): Individual and group psychotherapy withIndividual and group psychotherapy withCBT interventions, Cognitive Processing Training (CBT interventions, Cognitive Processing Training (CPTCPT))


26/49


MEMORY FUNCTIONING REHABILITATIONMEMORY FUNCTIONING REHABILITATION

Goal:Goal: Reduce Soldier'sReduce Soldier's hyperarousalhyperarousal to increase ability toto increase ability tofocus and attend, and improve memory functioningfocus and attend, and improve memory functioning(encoding and retrieval) through(encoding and retrieval) through hippocampalhippocampal

rehabilitationrehabilitation

Intervention(sIntervention(s):):

HyperarousalHyperarousalreduction:reduction:Acupuncture, biofeedback,Acupuncture, biofeedback,Reiki, medical massage, daily power walk, daily physicalReiki, medical massage, daily power walk, daily physical

training, water polo, meditation and movement therapiestraining, water polo, meditation and movement therapies((T'aiT'ai

Chi, Qigong, Yoga)Chi, Qigong, Yoga)

Improvement inImprovement inMemory Functioning:Memory Functioning:Brain TrainBrain Train(computer(computer--based cognitive rehabilitation program)based cognitive rehabilitation program)


27/49


EMOTIONAL/GRIEF WORKEMOTIONAL/GRIEF WORK

Goal:Goal:

Reduce Soldier's emotional reaction to distressingReduce Soldier's emotional reaction to distressing

combat memories/images, reduce frequency ofcombat memories/images, reduce frequency of

reexperiencingreexperiencing, flashbacks and blackouts, flashbacks and blackouts


Individual and group psychotherapy,Individual and group psychotherapy,

expressive (art) therapy focused on emotional processing andexpressive (art) therapy focused on emotional processing and

griefworkgriefwork, Reiki, Meditation Room with, Reiki, Meditation Room with TherasoundTherasound


28/49


SLEEP IMPROVEMENTSLEEP IMPROVEMENT

Goal:Goal:

Increase duration and quality of sleep (restorative andIncrease duration and quality of sleep (restorative and

uninterrupted)uninterrupted)

Intervention(sIntervention(s):): Sleep hygiene education, physical arousalSleep hygiene education, physical arousalreduction (below), emotion/grief work (abovereduction (below), emotion/grief work (above

to reduceto reduce

nightmares, sleep restlessness, sleepwalking), and medicationnightmares, sleep restlessness, sleepwalking), and medication

as necessaryas necessary


29/49


MILITARY REINTEGRATIONMILITARY REINTEGRATION

Goal:Goal:

Increase Soldier's ability to tolerate combatIncrease Soldier's ability to tolerate combat

environments and activitiesenvironments and activities

Intervention(sIntervention(s):): Engagement Skills Trainer (EST) 2000Engagement Skills Trainer (EST) 2000(indoor simulated firing range); brief group missions (day(indoor simulated firing range); brief group missions (day-- long Habitat for Humanity mission)long Habitat for Humanity mission)Planned:Planned:Live range firing, shoot houses,Live range firing, shoot houses, IEDIED lane, weeklane, week--long Habitat for Humanity missionlong Habitat for Humanity mission


30/49


PHYSICAL AROUSAL REDUCTIONPHYSICAL AROUSAL REDUCTION

Goal:Goal:

Reduce Soldier's physical agitation, aggressiveness,Reduce Soldier's physical agitation, aggressiveness,

startle response, muscularstartle response, muscular hypertonicityhypertonicity

Intervention(sIntervention(s):): Acupuncture, biofeedback, Reiki, medicalAcupuncture, biofeedback, Reiki, medicalmassage, meditation, daily power walk, daily physicalmassage, meditation, daily power walk, daily physicaltraining, water polo, and movement therapies (training, water polo, and movement therapies (T'aiT'ai

Chi,Chi,

Qigong, Yoga), medication as necessaryQigong, Yoga), medication as necessary


31/49


RERE--SOCIALIZATION /FAMILY REINTEGRATIONSOCIALIZATION /FAMILY REINTEGRATION

Goal:Goal:

Increase Soldier's tolerance for/ability to engage inIncrease Soldier's tolerance for/ability to engage in

social interaction with comrades, friends, emotional closenesssocial interaction with comrades, friends, emotional closeness

with familywith family


Recreation Room atRecreation Room at R&RR&R

Center,Center,

Therapeutic Outings (planetarium, golf, bumper cars, waterTherapeutic Outings (planetarium, golf, bumper cars, water

polo), Family and Couple Therapy, Couples Groups/Retreats,polo), Family and Couple Therapy, Couples Groups/Retreats,

Family NightsFamily Nights


32/49


SPIRITUAL HEALINGSPIRITUAL HEALING

Goal:Goal: Help Soldiers:Help Soldiers:

rere--gain a cohesive sense of self;gain a cohesive sense of self;

incorporate combat experience into the "meaning" of their lives;incorporate combat experience into the "meaning" of their lives;

work through issues of death, dying and killing; andwork through issues of death, dying and killing; and

resolve any confusion evoked by combat about God or higher powerresolve any confusion evoked by combat about God or higher power..


Individual/group psychotherapy, counselingIndividual/group psychotherapy, counseling

by Center chaplain, Reiki, meditation, mindfulness training,by Center chaplain, Reiki, meditation, mindfulness training,

crosscross--cultural group experiences (Native American sweatcultural group experiences (Native American sweat

lodge, Apache warrior healing ritual after killing, etc.)lodge, Apache warrior healing ritual after killing, etc.)


33/49

Intensive Family ProgramIntensive Family Program

Evening hoursEvening hours

(ACS/Soldiers providing child care as needed)(ACS/Soldiers providing child care as needed)

Intervention with PostIntervention with Post--Deployment FocusDeployment Focus

Family TreatmentFamily Treatment

Spouse Counseling (includes Alternative Medical)Spouse Counseling (includes Alternative Medical)

Couple CounselingCouple Counseling

Spouse GroupSpouse Group

Couples GroupCouples Group

Kids GroupKids Group

Parenting Education (ACS)Parenting Education (ACS)

Family/Couple EventsFamily/Couple Events

Marriage EnrichmentMarriage Enrichment

Family NightsFamily Nights

Linkages with School PersonnelLinkages with School Personnel


34/49

Typical ScheduleTypical Schedule


35/49

Typical Program (32 hours)Typical Program (32 hours)

Typical Soldier every week gets:Typical Soldier every week gets:

22 --

11--hour Individual Psychotherapy sessions/weekhour Individual Psychotherapy sessions/week

(1 Primary, 1 Secondary Therapist)(1 Primary, 1 Secondary Therapist)44 --

11----hour Psychotherapy groupshour Psychotherapy groups

11 --

11--hourReiki session/week (more at outset ofhourReiki session/week (more at outset oftxtx))

11 --

11--hourMedical massage sessionhourMedical massage session

11 --

11--hourAcupuncture sessionhourAcupuncture session

44 --

11--hour Movement Therapy groupshour Movement Therapy groups

44 --

11--hour Art Therapy groupshour Art Therapy groups

44 --

--hour Meditation groupshour Meditation groups

11 --

11----hour Lifestyle Education grouphour Lifestyle Education group

55 --

--hour Power Walkshour Power Walks

22

22--hour water polo sessionshour water polo sessions

44 --

11----hourPhysical Training Sessions withhourPhysical Training Sessions with NCOICNCOIC

11 --

44--hour Therapeutic Outinghour Therapeutic Outing

11 -- 20 min. Med. Management Appt every 2 weeks (more as necessary)20 min. Med. Management Appt every 2 weeks (more as necessary)


36/49

StaffStaff (15.5(15.5 FTEsFTEs))

Chief (Supervising PsychologistChief (Supervising Psychologist --

YCYC--2 )2 )

Administrator (GSAdministrator (GS--9)9)

Clerk (GSClerk (GS--5)5)

Clinical Director (PsychologistClinical Director (Psychologist

GSGS--13)13)

NCOICNCOIC

((SFCSFC

WTUWTU))

2 Clinical Social Workers (GS2 Clinical Social Workers (GS--11)11)

2 Family Therapists (2 Family Therapists (LCSWLCSWss

GSGS--11)11)

1 Psychology Technician (GS1 Psychology Technician (GS--8)8)

1 Acupuncturist (Contract)1 Acupuncturist (Contract)

22 --time Reiki Master Teachers (Contract)time Reiki Master Teachers (Contract)

22 --time Medical Massage Therapists (Contract)time Medical Massage Therapists (Contract)

11 --time Movement Therapist (Contract)time Movement Therapist (Contract)

11 --time Art Therapist (Contract)time Art Therapist (Contract)

11 --time Prescriber (M.D. ortime Prescriber (M.D. or N.PN.P.) (.) (CMHSCMHS))

11 --time Chaplain (time Chaplain (WTUWTU))


37/49

Lessons LearnedLessons Learned

30 SOLDIERS IN A GROUP FOR 6 MONTHS30 SOLDIERS IN A GROUP FOR 6 MONTHS FORM AFORM A

PLATOONPLATOON

TheThe WolfpackWolfpack

WeWere not weakre not weak

IIve got your backve got your back

A PLATOON OF 30 SOLDIERSA PLATOON OF 30 SOLDIERS NEEDS ANNEEDS AN NCOICNCOIC

Believe it or not, Soldiers (like most people) will try to get oBelieve it or not, Soldiers (like most people) will try to get out ofut of

thingsthings

This is not AlbertsonThis is not Albertsonss

didndidnt ultimately workt ultimately work

NCOICNCOIC

fromfrom WTUWTU, not, not DMHDMH

was best (organic connection to theirwas best (organic connection to their

unit leadership)unit leadership)


38/49

More Lessons LearnedMore Lessons Learned

GROUP MENTORSHIP/DYNAMICSGROUP MENTORSHIP/DYNAMICS CRUCIAL/TRICKYCRUCIAL/TRICKY

Older guysOlder guys

sponsorsponsor newer guysnewer guys

Soldiers wearSoldiers wear PTsPTs

no rank in the programno rank in the program

Soldier to Soldier program atSoldier to Soldier program at WTUWTU

DISENROLLMENTS/MEBsDISENROLLMENTS/MEBs

HARDHARD

A threat to people in the groupA threat to people in the group

Often tumultuousOften tumultuous

Staff feelings of failureStaff feelings of failure


39/49


MILIEU IS VERYMILIEU IS VERY INTENSEINTENSE

ExhilaratingExhilarating

ExhaustingExhausting

Groups very heavyGroups very heavy

Compassion fatigue/burnout significant staff threatCompassion fatigue/burnout significant staff threat

Critical importance of Provider Resiliency TrainingCritical importance of Provider Resiliency Training

SIZE ISSIZE IS CRITICALCRITICAL

Our Optimal Number is 30Our Optimal Number is 30

Keeps group cohesiveKeeps group cohesive

Keeps therapy groups smallKeeps therapy groups small

Precludes participants gettingPrecludes participants getting lostlost

Somewhat dictated by buildingSomewhat dictated by building


40/49


CADRE EDUCATIONCADRE EDUCATION ESSENTIALESSENTIAL

FORSCOMFORSCOM

Leadership skeptical (SIX months!?!) and stigma persistsLeadership skeptical (SIX months!?!) and stigma persists

WTUWTU

Leadership mostly nonLeadership mostly non--medicalmedical

PTSDPTSD

Education crucial to avoid undercutting programEducation crucial to avoid undercutting program

ManyMany WTUWTU

Cadre areCadre are closetcloset

PTSDPTSD

casescases

STAFF COHESION ASTAFF COHESION A CHALLENGECHALLENGE

Dynamics as intense as among the SoldiersDynamics as intense as among the Soldiers

Intentional staff processing crucial (consultant)Intentional staff processing crucial (consultant)


41/49


FOCUS ONFOCUS ON MISSIONMISSION

1.1.

Soldiers sometimes have significant problematic personality traiSoldiers sometimes have significant problematic personality traits.ts.

2.2.

These traits may play a significant role in their susceptibilityThese traits may play a significant role in their susceptibility

toto

PTSDPTSD..

3.3.

These traits also are a significant challenge in their recoveryThese traits also are a significant challenge in their recovery fromfrom

PTSDPTSD..4.4.

When Soldiers with personality traits are in treatment for 6 monWhen Soldiers with personality traits are in treatment for 6 months,ths,

you canyou cant ignore them.t ignore them.

5.5.

Nevertheless, WE ARE NOT THERE TO TRANSFORMNevertheless, WE ARE NOT THERE TO TRANSFORM

PERSONALITIES.PERSONALITIES.

6.6.

Keeping that in mind is easier said than done.Keeping that in mind is easier said than done.

7.7.

When the PD outshines theWhen the PD outshines the PTSDPTSD, you, youve reached baseline.ve reached baseline.


42/49

ResearchResearch

Overall Effectiveness:Overall Effectiveness:

Does theDoes the R&RR&R Center approach to treatmentCenter approach to treatment

increase the retention of Soldiers withincrease the retention of Soldiers with PTSDPTSD??

Will measureWill measure R&RR&R Center program versusCenter program versus

standard carestandard care at Community Mental Healthat Community Mental Health

Service.Service.

ThreeThree--year study using a variety ofyear study using a variety of

psychological measures.psychological measures.


43/49

Integrative Medical Studies:Integrative Medical Studies:(Partnering with(Partnering withUTEPUTEP))

Reiki:Reiki:Several outcome designs measuringSeveral outcome designs measuring

therapeutic effect as well as effect of frequencytherapeutic effect as well as effect of frequency

Expressive Therapy:Expressive Therapy:Therapeutic effect ofTherapeutic effect of

Photo Essay TherapyPhoto Essay Therapy

Movement Therapy:Movement Therapy:Therapeutic effect of kickTherapeutic effect of kick--

boxing (no contact) and water aerobicsboxing (no contact) and water aerobics

ResearchResearch


44/49

PTSD/mTBIPTSD/mTBIStudy:Study:

Spearheaded and funded by the U.S. ArmySpearheaded and funded by the U.S. ArmyAeromedicalAeromedicalResearch Laboratory at Ft. RuckerResearch Laboratory at Ft. Rucker

Will examine theWill examine thecomorbiditycomorbidityofofmTBImTBIandandPTSDPTSD

Will explore possible ways to discriminate betweenWill explore possible ways to discriminate between

them in the interest of improving treatmentthem in the interest of improving treatment

ResearchResearch


45/49

Drum roll . . . . . .Drum roll . . . . . .

P li i D tPreliminary Data


46/49

NOTE: All Soldiers admitted to the R&R Center program wouldNOTE: All Soldiers admitted to the R&R Center program wouldotherwiseotherwise

have been discharged by MEBhave been discharged by MEB

Therapeutic EffectivenessTherapeutic Effectiveness ((1 Sep 20071 Sep 2007--30 Jun 2008):30 Jun 2008):

Admitted: 56Admitted: 56

Disenrolled:* 5Disenrolled:* 5

MEB'd :** 5MEB'd :** 5

Currently in Treatment: 3Currently in Treatment: 300

Returned FFD to branch: 16Returned FFD to branch: 16

Retention rate: 61%Retention rate: 61%

* 2 disenrolled at Soldiers' request, 3 for non* 2 disenrolled at Soldiers' request, 3 for non--compliancecompliance

** Physical conditions not identified at enrollment** Physical conditions not identified at enrollment

Preliminary DataPreliminary Data

& Projections& Projections

P li i D tPreliminary Data


47/49

Cost Effectiveness:Cost Effectiveness:

Projected Number of Soldiers To Be Treated per year: 100Projected Number of Soldiers To Be Treated per year: 100

Projected Number Expected to Return to Force: 61Projected Number Expected to Return to Force: 61

Projected Program Cost FY 2008: $1.4 millionProjected Program Cost FY 2008: $1.4 million

Projected Cost Per Soldier Returned to Force: $22,950Projected Cost Per Soldier Returned to Force: $22,950

Projected Numbers based on enrollment in last two quarters; enroProjected Numbers based on enrollment in last two quarters; enrollment in first quarterllment in first quarterwas below capacity because of 1) challenges hiring staff and 2)was below capacity because of 1) challenges hiring staff and 2)cautious initial responsecautious initial response

of line units at Ft. Bliss to refer Soldiers to the program.of line units at Ft. Bliss to refer Soldiers to the program.

Preliminary DataPreliminary Data

& Projections& Projections


48/49

What will longWhat will long--term attrition look like?term attrition look like?

Can this program be replicated, how and where?Can this program be replicated, how and where?

Availability of staff at other locations?Availability of staff at other locations?

What aboutWhat aboutMMRBMMRBss??

Your Questions?Your Questions?

Our QuestionsOur Questions


49/49

Documents

20110510 PTSD Ft Bliss RRCENTER Presentation