JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas -- Army Spc. Jen Smith* struggled with the aftermath of a sexual assault for nearly six months before she hit rock bottom. Plagued by nightmares and depression, Smith told her supervisor she was contemplating suicide.

"I was at the end of my rope and that was my cry for help," she said. "I knew something had to change."

Smith was referred to Brooke Army Medical Center's Intensive Outpatient Program for Post-traumatic Stress Disorder, which proved a game-changer for the Soldier. "It was like my prayers had been answered," she said.

Since attending the program last year, "My life and my attitude have changed," Smith said. "I went from complete isolation to going out and having fun with friends again. Life isn't perfect, but the program has given me an amazing foundation to build from."

BAMC's six-week program launched two years ago to offer short-term, focused care to service members with PTSD resulting from traumatic experiences such as combat, childhood abuse, or sexual trauma. Providers have seen tremendous success combining individual and group sessions with evidence-based treatments, explained U.S. Public Health Service Capt. Richard Schobitz, the program's chief.

"The program is making a tremendous impact and is changing lives for patients with PTSD," he said.

When they first begin the program, many patients are suicidal or struggling with substance and alcohol abuse. The resultant depression and anxiety can lead to crippling isolation, Schobitz noted, as well as nightmares, insomnia, panic attacks and outbursts of anger.

"Patients with PTSD are less apt to engage with family and friends and do enjoyable activities, such as going to birthday parties or the pool with their kids," he said. "Some stop leaving their homes at all. We focus on helping our patients recapture the joy in their lives."

Providers encourage patients to end the isolation and re-engage with the world around them through therapies called Prolonged Exposure and Acceptance and Commitment. They take trips downtown and to department stores, and re-learn how to navigate crowds. They also focus on mindfulness, or being present in the moment, Schobitz said, an important aspect of Acceptance and Commitment Therapy.

"PTSD patients often dwell in the past or have anxiety about the future," he said. "Walking around gardens at the Warrior and Family Support Center, observing nature, just being present in the moment, can be very healing. We want patients to feel their emotions, not fight them."
Providers also encourage patients to identify and take steps to achieve their values, such as being a better spouse or parent.

Smith is among the nearly 100 service members who have attended the program. The success has been impressive across the board, Schobitz noted, both anecdotally and statistically.

At the conclusion of a recent female-only cohort, the scores on the Post-traumatic Diagnostic Scale, or PDS-5, a self-report measure used to measure the severity of PTSD symptoms, decreased by an average of 49 points. This is important as PDS-5 scores range from 0 to 80, with 80 reflecting the most severe symptoms, noted Melissa Ramirez, a licensed clinical social worker at the program.

Other cohorts have reported a nearly 25 point drop on the PDS-5, she said. "A drop of 10 is significant," she said. "We're doubling that on average in only six weeks.

"These results are very rewarding," she added. "We see service members who are five to 30 years post-trauma, and it's had a major impact on their lives. We are seeing people regain the joy in their lives, reconnect with their loved ones … they still have moments of challenge, but now they can better handle it."

Ramirez said what's most striking is the difference in their appearance post-program. Providers take a photo of patients at week 1 and during the final week. "There's a profound difference in their face, she noted. "In the final week, they look well-rested, less stressed, happier, more relaxed. The impact is highly visible."

A year out from the program, Smith has good days and bad, but feels confident she now has the tools to cope. "I still see counselors to keep myself on track. But I'm doing so much better than I would have done otherwise," she said. "My biggest takeaway is life does go on. It gets better.

"It's important to step forward and get help," she added. "People do care. If you don't find the help you need right away, keep asking. Keep on searching for what's going to help you."

For more information on the Intensive Outpatient Program, speak to your provider or call Schobitz at 210-808-2585.

(Note: Smith's name was changed to protect her privacy.)