August 21st, 2013

Exercise program geared toward treatment reluctant veterans

The Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass. (Bedford VAMC) will offer an exercise program designed to engage and motivate veterans who shun traditional forms of treatment for mental health problems.

Attorney General Martha Coakley’s Office awarded a $60,000 grant for the project through the Bedford VA Research Corp. Inc (BRCI), a private non-profit that provides an avenue for VAMC to get funds from non-VA sources.

VAMC psychologists Holly Parker, Ph.D. and Ed Federman, Ph.D., developed the project, noting that only 25 percent of veterans receive the help they need for a variety of reasons. “Mental health treatments carry a stigma as the most frequent barrier to even walking into a clinic. Many veterans have a hard time talking to therapists or opening up about emotions,” Parker says. Other veterans can’t respond to or tolerate medications.

This exercise approach is unique, Federman says, because it’s designed to engage and motivate these “hard to reach” individuals. “You can give a veteran a pass to a gym that will sit on the counter. Here, we’ll build a social support network of like-minded people and help them to move forward.”

The hospital already has a running program for returning vets with PTSD that Parker says helps participants manage stress, regulate emotion, set goals and break barriers with civilians by getting out in the community. The new initiative is a “natural next step,” that reaches out to veterans who refuse traditional treatment.

Parker, who is a certified trainer, will act as group leader. She says that each participant will work at his/her own fitness level, create goals and engage in activities like running, swimming, biking, cross and weight training, walking and cardiovascular exercises. Each group will meet for six months and participants will work out individually twice per week and in a group twice per week.

She describes the exercises as “consistent, monitored, purposeful and targeted,” emphasizing that moderation will be the key. “Some vets exercise too much and that’s worse. It happens particularly with people with PTSD. We’ll make sure they are put into a moderate zone and not doing harm to themselves.”

She expects that veterans will experience a marked reduction in stress, suicidal thoughts, depression and anxiety and an improvement in their ability to function. Research backs up those expectations, Parker adds. “To the extent that emotional pain is promoting substance abuse as it so often does, this treatment should reduce substance abuse as well.”

Parker says the challenge will be to measure progress and outcome. “The veterans coming in don’t believe they have a problem or don’t want to open up. We’ll track them without stepping on our own feet and making them feel like they are in traditional mental health treatment.”

At the end of the cycle, veterans will be given information about the Veterans Crisis Line as well as the range of mental and physical health services available at the Bedford VA and contact numbers, although Parker says that many participants may not need mental health services by then. “We’ll make sure they know the door is open,” Parker says.

Outreach and recruitment for about three months is the immediate focus before the project’s launch. Federman is now acting as a consultant and Charles French and Jerry Kinsky, MSW, LCSW, will work on “finding veterans who don’t want to be found,” according to Parker. An administrative assistant will likely be hired.

It’s anticipated that six groups or 60 vets total will have been served by the end of the two-year pilot project. All involved anticipate that the program will become on-going, self supporting and sustainable.

“As a field, we need to meet veterans where they are and find a way to give them treatments they’re willing to try. This program is our attempt to step in their direction,” Parker says. “We’re looking forward to working with the brave men and women who served this country and offering them another pathway to living the lives they deserve.”

By Susan Gonsalves

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