Does RESET Facilitate Recovery?
The Warrior Combat Stress Reset Program (Reset) combines multiple treatment interventions from behavioral health, mind/body treatments, and Complementary and Alternative Medicine (CAM) modalities to treat combat stress and post-traumatic stress symptoms.
Our program evaluation at Fort Hood found that the program's focus on reducing core symptoms of combat and post-traumatic stress (hyper-arousal and reactivity) allowed other treatments to be more effective and provided tools for preventing future trauma.
Samueli Institute has increased the program's capacity for evaluation by building a database repository, entering retrospective data, creating report capability and developing a follow-up system to allow for sustainability tracking.
Background:
The Warrior Combat Stress Reset Program (Reset) is a unique, multi-modal, integrative model program for the treatment of symptoms of combat stress and Post Traumatic Stress Disorder (PTSD). Reset is designed for Soldiers who are committed to an intensive and structured program of treatment and whose goal is to further their careers with continued service in the United States Army. It is structured as a three-week intensive program focused on reducing hyper-arousal and reactivity.
The main goal of the Reset program is to facilitate recovery from trauma through:
- Restoring access to “relaxation response”/inner quieting;
- Improving sleep & self-regulation; and
- Facilitating recovery from “triggers” and intrusive memories.
The combination of multiple treatment interventions from behavioral health, mind/body treatments, and CAM modalities provides opportunity for intense treatment but also poses some unique program evaluation challenges. Soldiers are expected to attend Reset daily from 0730 to 1630 throughout the three-week period and then must commit to eight weeks of weekly group therapy after completion of the program. Reset program components include group and individual counseling, self-regulation skills training, biofeedback, coping skills education and training, Eye Movement Desensitization and Reprocessing (EMDR) therapy, Cranial Electrical Stimulation, and other integrated CAM modalities (e.g. Acupuncture, Reiki, Massage, Meditation, Yoga, and Tai Chi).
Project Goal:
Samueli Institute was invited to design and conduct this Program Evaluation by the program’s leadership. The goal of this research project is to determine the extent to which the goals, objectives and outcomes of the Reset program are being achieved.
Specific Aims:
Conduct a formal program evaluation of the Reset program. This involves three levels of evaluation: (i) structural evaluation; (ii) process evaluation; and (iii) outcome evaluation. Such an approach is based on discovering the unique factors within a program and site of implementation (leadership, relationships, culture, structure, rewards) that bring about the outcomes.
- Determine whether or not Reset is being implemented according to its own guidelines
- Identify facilitators and barriers to the expanding the program and replicating it at other locations
- Develop a comprehensive description of Reset in order to assess the extent to which the program is replicable.
- Conduct an outcomes evaluation to ascertain the extent to which the proposed goals, objectives, and results of Reset are being achieved.
- Identify potential mechanisms that account for success or failure of the program by collecting qualitative data from Reset stakeholders, including patients and their family, program providers, and hospital command. (The program structure, logistics, replicability, and quality can only be evaluated through qualitative inquiry. Further, evaluation of Service Member acceptability and satisfaction with a program, their attitudes, beliefs, and opinions is most appropriately achieved through interviews with patients.)
Study Status:
Two data collection site visits to Fort Hood were completed in February and March 2012 and 61 interviews were conducted with program providers, staff, patients, referring providers, family members, and hospital leadership. In an effort to build capacity for continued self-monitoring and evaluation, additional follow-up data collection points were added at eight and 12 weeks after the end of treatment. Concurrently, an MS Access-based database has been developed, in conjunction with program staff. This database contains retrospective outcomes data for more than 600 soldiers who have received the Reset Program. Qualitative and quantitative data are currently being analyzed.
Significance:
Results from this project will supply important and unique scientific information of direct relevance for the public. This includes making available new data on the effectiveness of an Integrative approach to the management of PTSD and related symptoms. Reducing these core symptoms of combat stress and PTSD allows other treatments to be more effective. It also provides tools for mitigating adverse effects of future trauma.