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An Intensive Outpatient Program for Veterans With Posttraumatic Stress Disorder and Traumatic Brain Injury
Authors:Margaret M. Harvey  Timothy J. Petersen  Julia C. Sager  Nita J. Makhija-Graham  Edward C. Wright  Erika L. Clark  Lauren M. Laifer  Lauren K. Richards  Louis K. Chow  Louisa G. Sylvia  René M. Lento  Laura K. Harward  Joan Clowes  Valerie Brathwaite  Laura K. Lakin  Noah D. Silverberg  Grant L. Iverson  Eric Bui  Naomi M. Simon
Affiliation:Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, Harvard Medical School, and University of Massachusetts Medical School;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, and Harvard Medical School;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, and Harvard Medical School;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, and Harvard Medical School;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston;University of British Columbia;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, Harvard Medical School, and Spaulding Rehabilitation Hospital, Charlestown, MA;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, and Harvard Medical School;Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston, and Harvard Medical School, and NYU Langone Health
Abstract:Post-9/11 service members may return from military service with a complicated set of symptoms and conditions, such as posttraumatic stress disorder (PTSD), depression, substance misuse, and traumatic brain injury (TBI), that interfere with reintegration and impair functioning. Although evidence-based treatments that facilitate recovery exist, their successful delivery at a sufficient dose is limited. Barriers to accessing treatment combined with challenges compiling a comprehensive treatment team further delay delivery of effective evidence-based care for PTSD, TBI, and co-occurring mental health conditions. This paper describes the development of a comprehensive, multidisciplinary, 2-week intensive day program for post-9/11 veterans with complex mental health concerns. The treatment program combines skill building groups, family education, and integrative health approaches with evidence-based individual PTSD or TBI care. Initial results from the first 132 participants were notable for a 97% completion rate, as well as statistically significant and clinically meaningful reductions in PTSD, neurobehavioral, and depression symptom severity for the 107 veterans who completed the PTSD track and the 21 who completed the TBI track. These data suggest the intensive program approach is an effective, well-tolerated model of treatment for post-9/11 veterans with PTSD and/or TBI. Future controlled studies should examine the effectiveness of this intensive model compared to standard evidence-based therapy delivery, as well as longitudinal outcomes.
Keywords:posttraumatic stress  traumatic brain injury  intensive treatment  veteran  service member
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