WASHINGTON (Army News Service) -- Preliminary results indicate that therapeutic retreats can reduce post-traumatic stress symptoms in veterans and improve relationships for both veterans and their caregivers.The results come from four-day healing retreats studied by the Institute for the Health and Security of Military Families. During the retreats, participants were presented with a variety of activities, including PTSD education, acupuncture, yoga and art therapy, according to Dr. Briana S. Nelson Goff, director of the institute.For her work in PTSD therapy and research, Goff will be presented with the Outstanding Civilian Service Award at the Chief of Staff of the Army Salute during a Twilight Tattoo ceremony at Joint Base Myer-Henderson Hall, Virginia on Thursday, Sept. 15.A VARIED APPROACHWhat works for one person might not work for another, Goff said. So the participants -- veterans and their spouses, parents and battle buddies -- were exposed to a variety of different experiences. In addition to traditional therapeutic activities, participants engaged in group recreational activities like kayaking, hiking, and dance lessons.The beneficial effects of the activities can be cumulative, Goff said, rather than relying on one intervention alone to reduce PTSD symptoms."We are here to supplement or assist with their treatment, not replace their treatment," Goff said, adding that not all of veterans who attended the retreats were receiving formal treatment.The retreat model, known as "Bridging the Gap," first began in 2011 with Soldiers from Fort Riley, Kansas, and veterans from Kansas City and Wichita. Over time, the model has expanded to Chicago, Florida, Georgia, and Washington, D.C., according to Goff. To date, 12 retreats have taken place and more than 200 veterans and their caregivers have attended.The group at each retreat is quite small, and each service member or veteran who participates must attend with a caregiver -- a spouse, parent, sibling -- anyone who will be there to support the person. The only financial cost to the attendees, Goff said, is transportation to the retreat. Bridging the Gap is branching farther out so veterans won't need to travel as far.Since 2015, funding for the retreats has been provided through a grant from the Walter Reed Society, a nonprofit group that aims to benefit Walter Reed Army Medical Center and its educational, patient, treatment, and research activities.PTSD RESEARCHAt the retreats studied by Goff, data were collected using standardized questionnaires and each day participants were administered non-invasive salivary cortisol testing. Cortisol is the stress hormone in the body. Higher levels of the hormone in the saliva indicate higher levels of stress, she explained.Goff said data from the salivary cortisol testing is currently being analyzed and results could be available as early as this month. This additional data will provide unique information about whether the retreats are having a positive impact on the participants' physical health."Our data indicates that they are experiencing lower PTSD symptoms by the end of the retreat," she said. "This [cortisol testing] will allow us to learn whether there are any biological and physiological changes over the four days."ABOUT PTSDPTSD isn't always combat-related, said Goff. Domestic violence, sexual assault or child abuse can also trigger the condition.Having worked in PTSD treatment and research for 25 years, Goff is convinced that the condition is a chronic illness, rather than an acute one. Just like diabetes, the condition can be managed with treatments like therapy and medication, she believes."It doesn't mean you can't have a full and productive life," she said. "But you have to manage the symptoms for the rest of your life. If we as a society and we as a profession change our perception, it would completely change the field."Goff has been studying the effects of combat trauma and other traumatic experiences since the early 1990s when she was a graduate student intern with the Department of Veterans Affairs. There, she gained experience working on a PTSD unit, providing family therapy to veterans and their caregivers.Since 2009, she has served as the director of the Institute for the Health and Security of Military Families at Kansas State University, where she is in charge of developing collaborative educational, outreach and clinical services programs for military families in the state.She has led a number of research projects focused on combat trauma, including leading the research on the Bridging the Gap retreats.