In just three years, the Brattleboro Retreat Uniformed Service Program (USP) in Vermont has helped about 1,200 uniformed service professionals deal with issues including stress, substance abuse, trauma and depression.
USP is a rigorous, brief (average stay is 10 days) partial hospitalization program for active and/or retired members of a uniformed service, such as police, fire, corrections, military, EMTs and paramedics. Its structured and supervised psychotherapy program focuses on rapid clinical change, reduction of symptoms and stabilization, and transitioning to outpatient service providers. Participants have come from throughout the U.S. and also included military from Europe.
USP helps uniformed service professionals deal with PTSD and later this year or in early 2013 will launch an intensive outpatient PTSD program, says psychologist Frank J. Gallo, Ph.D., USP program director.
Before becoming a psychologist, Gallo’s life experience gave him insight into USP patients: he is a retired R.I. police officer.
Gallo says uniformed service providers are vulnerable to the stigma attached to help-seeking behavior. “That stigma – that my peers will see me as being weak – is a really a big barrier to change,” he says.
Gallo says the USP program aims to help first responders understand that it’s okay to be sad or feel vulnerable and helps them deal with issues such as a peer lost in the line of duty. “We want to get them to understand that these are just reminders of something that was important, like a person who was lost, rather than something toxic or a sign of weakness or vulnerability.”
Feeling pain is evidence that you had someone of value in your life, he says. For example, if you have children and worry about something bad happening to them, you are willing to accept that risk of pain, because having children is the very thing you want.
“We try to teach them that pain is just part of living a more vital, meaningful life and that becomes transformative for them. They are able to talk about their experiences easier. It kind of transforms from being something that was dangerous and threatening. We facilitate, in kind of a safe place, an opportunity for people to go into things that were so painful to them they thought they could never discuss them. They find value in the very thing they’ve been avoiding.”
The peer aspect is important, Gallo says. “When they come into the (USP) program and see there are others just like them struggling with their stuff, that’s very normalizing for them. They see, ‘I’m not alone in this. We’re in this together.’ That’s a pretty powerful mechanism of change for people.”
The program is primarily in a group therapy setting, but each participant also has an assigned clinician. Participants are encouraged to stay with their peers at the retreat’s nearby inn.
USP programs include mindfulness training. In Acceptance and Commitment Therapy (ACT) groups, uniformed service professionals practice being present in the moment, and noticing painful personal experiences such as thoughts, emotions, and memories and being willing to observe and accept rather than avoid them.
USP also includes trauma informed yoga, sleep and dream therapy and self-compassion skills training with an emphasis on self-caring and self-soothing. “That’s a big problem in the uniformed service profession. They are beating themselves up with guilt or shame or are embarrassed and think ‘Is there something I could have done better?’ We’re looking to increase psychological flexibility. We want them to be aware of what’s going on in their outside and inside world, have experiences without evaluation and judgment and get them doing things that are important.”
Gallo says the USP takes into account evidence from the field and participants. “Our program is really data-driven. There’s elasticity to the program.”