Residential Treatment Facility Inpatient Service celebrates

Theresa A. Brisker
Behavioral Health Clinical Nurse Educator
Eisenhower Army Medical Center
Eisenhower Army Medical Center's Residential Treatment Facility's Inpatient Service -- after many hours of research, discussion, planning and final approval with funding from the Office of the Surgeon General -- opened August 2009 and accepted its first patients the next month on Sept. 9, as a 10-bed pilot program.

The RTF leadership team, Col. Philip Horton, medical director; Dr. Janet Lenard, clinical director; Theresa A. Brisker, CNOIC, and Sgt. 1st Class Tyeisha William-Reynolds, CNOIC; were focused, dedicated and charged with ensuring the RTF would be a program that was effective and would help to "conserve the fighting strength."

The RTF's mission is to provide intensive inpatient residential treatment for active duty service members from all branches with alcohol and other substance dependence disorders, along with co-morbid disorders (PTSD, depression and mTBI), with the goal of returning these people to duty and enhancing the combat readiness of the U.S. military force.

Because of the hard work and effectiveness of the leadership and treatment team, the program grew rapidly. In October 2010, the program doubled, increased to 20 beds, and in October 2011 two additional beds were added. October 2014, bed capacity was increased to 28. In June 2018 the bed capacity was increased 30 beds. Because of the demand for addiction treatment a plan is in place to increase bed capacity to 36, however, due to staffing shortages, the increase remains a plan.

The inpatient RTF program uses multidisciplinary care including initial psychiatric, psychological testing and bio-psychosocial evaluations, discharge planning, rehabilitation team meetings and interventions with command, ongoing treatment discussion of multidisciplinary care and progress, and individualized therapies depending on a patient's needs. Participation in intensive group and individual therapy, life-enhancement skills building, relapse prevention, daily support groups to include Alcohol Anonymous, Narcotics Anonymous, etc., physical training, and interventions with families as needed are major treatment components.

The RTF treatment philosophy is that substance addiction/dependency is a progressive and chronic disease which is treatable.
At the RTF, treatment is based on abstinence, evidenced-based treatment, cognitive behavioral therapy, motivation counseling, stages of change, 12-step recovery models and other adjunct support therapies in treating addictions to include treatment for family members.

The number of military service members who have received treatment from the facility's 2009 opening through July 2019 is 2,815 people. A battalion can be between 500-800 people, so the RTF inpatient service has treated what is equal to three to five battalions which is equal to a brigade.
Substance Use Disorder Clinical Care
The RTF staff conducts follow up data collection at 30, 90, 180 and 360 days after RTF Commencement. They contact the service member's SUDCC counselor and commander. The SUDCC counselor is asked to rate service member's attitude and compliance.

The Commander/1SG rates the service member's duty performance and attitude. RTF staff has received the following feedback:

SUDCC counselor
• "It wasn't until he received intensive treatment that he 'got it'."
• "Has come so far in 9 months … better relationship with parents."
• "He really has gotten a lot out of it … all of our guys we send down there have taken a lot away from treatment. He still references it."
• "Saw a dramatic change in attitude with accepting his alcohol problem …"
• "He talks very fondly and with great respect about how the program combines PTSD and alcohol [treatment] …"
• "Doing well maintaining abstinence and very serious about maintaining his sobriety."

Chain of Command
• "I think it's a great thing and I'm glad the Army has this program …"
• "Excellent" performance and conduct since RTF.
• SM "highly motivated and I will send other SMs."
• SM "amazing since completion of RTF;" parent sent "thank you' letter to command for allowing him to attend.

Patient satisfaction stats
When patients are discharged, they complete a patient satisfaction survey. These are some of the results from the survey.
• 98 percent: RTF helped gain a better understanding of alcohol and substance addiction
• 98 percent: RTF motivated them to seek recovery from alcohol or substance addiction
• 97 percent: RTF staff was helpful in assisting with your concerns
• 96 percent: Medical concerns or problems were addressed during treatment

Defense Center of Excellence
The Defense Center of Excellence conducted an evaluation of the RTF. Through the DCoE program evaluation process and site visit to Fort Gordon, DCoE gained valuable insight into the successes and strengths of the RTF and identified three program strengths."
• Comprehensive care for addiction treatment and recovery
• Committed focus on reintegration of patients into the community
• Structured military milieu offers comfort and familiarity for patients
Therefore having Army leadership and highly structured military milieu is fundamental to the program's success.