Horses as Heroes for PTSD Vets https://grants.dudleytdoughertyfoundation.org/proposals-2012/horses-as-heroes-for-ptsd-vets https://grants.dudleytdoughertyfoundation.org/@@site-logo/sitelogo-75x75.png

Horses as Heroes for PTSD Vets

Additional Information
Used for	The equine therapy we utilize to reach and heal veterans who have returned home from being in war and are experiencing PTSD.
Benefits	Because the therapy is so successful veteran's who have gone through the program are significantly healthier, happier and able to integrate with their peers and community around them. They are less stressed, allowing them to go back to their families. They are more healed, allowing them to return to work. As a result of their of their treatment, they are able to be a part of their communities once again.
Proposal Description	Horses as Heroes for PTSD vets: EQUINE ASSISTED TREATMENT AS THE PREFERRED MODALITY Table of Contents: 1. Summary ………………………………………………………………………………………………………………… 3 2. Situation ………..…………………………………………………………………………………………………….… 3 3. Solution ……………………………………………………………………………………………………………….. 5 4. Objective ……………………………………………………………………………………………………………….. 5 5. How EAP works ………………………………………………………………………………………………….. 6 6. A Proven Treatment Methodology ……………………………………………..……………………… 7 7. Fundamentals of theModel EAP …………………………………………………………………... 7 8. Why horses? ………………………………………………………………………………………………………. 8 9. Treatment plan …………………………………………………………………………………………………… 9 10. Training modules/activities ………………………………………………………………………………… 9 11. Assessment tools ……………………………………………………………………………………………….. 10 12. Providers ……………………….……………………………………………………………………………………. 10 13. Location ……………………………………………………………………………………………………………. 11 14. Sustainability ……………………………………………………………………………………………………………. 12 15. Our Board…………………………………………………………………………………………………………………… 13 16. References…………………………………………………………………………………………………………………. 14 Equine Assisted Therapeutic Program Maintaining the psychological health, enhancing the resilience, and ensuring the recovery of service members and their families are essential to maintaining a ready and fully capable military force. - Report of the Department of Defense Task Force on Mental Health, June 2007 1. Summary • Needs addressed: There is an overwhelming need for mental health diagnosis and care, mental health care providers, and aid in the reintegration period. • Solution: A program utilizing Equine Assisted Psychotherapy (EAP) • Benefits: A treatment program which is hands-on and interactive has more appeal than the traditional office “talk therapy” and has fewer stigmas associated with it. The program effectively strengthens resilience characteristics and transitioning skills, and provides long-term treatment results with fewer sessions. • Establish a Pilot Program: Once the program is established, it will benefit veteran’s (from all walks of life, crossing gender, race, age, status and other societal caste divisions. • Cost: The cost for this program is $161,800. Of which, estimated transportation costs ($21,600) the Portland VA stated they will provide transportation for clients to and from the program. And Dr. Ron Turco has donated his time for the first year ($115,200) to help us get started A request of $25,000 is being requested from each funder solicited or the amount each funder’s guidelines cap at. To date, BEAT has only sent their program to a handful of potential funders. Among those asked: Bank of America, Private Client/Trust Services, Walmart, The Randall Charitable Trust, and the Meyer Memorial Trust. 2. Situation Recently, the news has been filled with reports on how the current medical and mental health infrastructure is unable to provide adequate care for our service members. According to an AP press release (June 15), about 35 percent of soldiers are seeking some form of mental health treatment a year after returning home. Army officials report 10,477 divorces among the active-duty force in 2004, a number that's climbed steadily since 2001 (DOD PR June 16, 2007). The effects of prolonged, recurring deployments can not only be seen in the workplace, but they are affecting family life as well. The Army has increased support to counter perceived stigmas about seeking mental health help, and is offering more programs to enhance marital relationships and support groups for their soldiers. There is a call to “revolutionize warrior care,” and much emphasis is put on providing the best treatment options. However, local communities are often overburdened by the amount of soldiers and their family members needing help, and therapy is often a long, drawn out process in an office setting. Despite increased training and preventative diagnostics, many soldiers still do not seek help, sometimes receiving prescription medicine that might mask underlying issues. Surveys of troops in Iraq have shown that 15 to 20 percent of Army soldiers have signs and symptoms of post-traumatic stress. There is an apparent need to accommodate the increasing demands for effective treatment modalities and diagnostics, to not allow service members to “fall through the cracks.” A report from a Defense Department task force released June 14, 2007 supports this statement. It found "current efforts fall significantly short" in providing help for our troops. "The psychological health needs of America's military service members, their families and their survivors, pose a daunting and growing challenge to the Department of Defense” (AP 06/ 15/2007). The psychological health needs of service members, their families and their survivors are daunting and growing. The evidence for this is substantial. Despite the suppressing effects of stigma, more than a third of active duty Soldiers and Marines self-report psychological health problems in the months following deployment, as do half of the members of the Reserve Component (DMSS, 2007). Rates of self-reported psychosocial and marital concerns are highest among service members exposed to the greatest degree of danger and who have repeatedly deployed. Further, the number of service members in these subgroups continues to grow (U. S. Army, 2006; Wheeler, 2007). The time for action is now. The human and financial costs of un-addressed problems will rise dramatically over time. Our nation learned this lesson, at a tragic cost, in the years following the Vietnam War. Fully investing in prevention, early intervention, and effective treatment are responsibilities incumbent upon us as we endeavor to fulfill our obligation to our military service members. - Report of the Department of Defense Task Force on Mental Health, June 2007 One important point of when stressors are at their peak is the reintegration period; when service members return from their deployments and enter “garrison life.” Nationwide training – Battlemind Training - offered to facilitate this process has already been implemented. However, these training sessions mostly consist of lectures and presentations. Coming back from a combat environment to a classroom environment poses certain challenges to the soldier. 3. Solution Equine Assisted Psychotherapy (EAP) is an emerging psycho-educational treatment modality incorporating horses experientially for emotional growth and learning. It is based on the EAGALA Model . We have been working with EAGALA to implement a similar program here in Oregon as they offer in Utah. It is our intent to start the program as soon as we have enough funding to get the project under way. Through carefully chosen activities, participants gain insights into their behaviors through “learning by doing.” Sessions are different in many aspects: groups of 8 or more can participate, thereby increasing treatment accessibility and shortening time to receive treatment. The classical therapeutic office model is taken out of context and placed in an arena with horses; interactions exist with the horses and a professional team of at least one licensed mental health professional (our volunteer pyschiatrist, Ron Turco who is a vet himself and treats PTSD) and at least one horse specialist. BEAT has five horse specialists/instructors. One of our instructors (Gabrielle Matney) already has experience in treating/working with vets with PTSD because she used to work with the equine group, HOPE in Ashland. She’s working with our Executive Director Phyllis Herinckx, to start a pilot program for veterans with PTD in Banks Oregon. All activities are “hands on;” lectures and long conversations are reduced to a minimum. Insights and changes in behavior do not necessarily occur by talking, but rather through the interaction with the animals. 4. Objective “Posttraumatic stress is an absolutely normal reaction to a very abnormal situation.” When not given the proper tools, symptoms of severe stress can manifest themselves into psychiatric disorders. (We see this in homelessness, inability to hold a job, reconnect with their families and loved ones, withdrawing from being an active participant in their communities.) Our objective is to provide our service members and their families a preventative safety net: the opportunity to practice and apply the tools set as standard by the Battlemind Training, therefore increasing the probability that current support systems are being properly used and severe reactions avoided. We are expecting the following outcomes: There will be a significant decrease in:  Family and marital disintegration  Domestic violence  Alcoholism and substance abuse  Suicide and self harm impulses There will be a significant increase in –  Smooth transitions from combat to garrison life  Increase in resilience  Effective coping and relationship skills  Healthy relationships and families  Better transitions to workforce 5. How Equine Assisted Psychotherapy (EAP) works The model of talk therapy involves reflection, instruction, insight, cognitive and emotional processes. The therapist acts as a catalyst for change and designs therapy sessions based on theoretical bias. The client takes emotional, cognitive, and psychological work from the therapy session back to everyday life and through a process of practice and reflection, change can occur. With EAP, clients have the opportunity to immediately practice and integrate new ways of being, because of the “in the moment” demands that interactions with animals require. The work of EAP has the potential to create change in the moment, thereby reducing required time to achieve desired results. Experiential (hands-on) training is a more effective approach to learning. This is especially true for those who join the armed services: their personalities thrive in a “hands-on” training environment. The Department of Defense already effectively incorporates this concept in the methods used to train our men and women for combat. To implement this same concept during the reintegration period will have an incredible impact: • Action, not talk – principles of healthy transitions are practically applied and practiced • Overcome barriers of care – Participants challenge themselves in activities with horses which removes much of the “stigma” associated with traditional “talk therapy” treatment methods. Participation in these activities makes this treatment modality more interesting and appealing, therefore increasing the probability of having a greater impact, being more successful. Horses respond to nonverbal communication which removes cultural barriers. • Solution-focused – participants must find their own solutions to proposed exercises through hands-on experience; they learn to rely on themselves and their team members • Fostering resilience – Experiential activities re-create frustrations, stressors, and relationship problems. Participants learn to adapt, improvise, and overcome perceived stressors as effectively at home as they do on the battlefield. • Focus on non-verbal communication – horses confront unhealthy non-verbal messages, providing awareness of how participants communicate and promoting change to healthy communication styles • Adaptability – participants must respond to the unpredictability and inability to “control” the horses and discover ways to make the relationship work Weapons proficiency is a relatively easily learned skill. Combat tactics are thoroughly taught and reinforced in war games. Physical fitness is extolled as the primary individual preparation for military service. However, little attention is paid to enhancing cognitive fitness and psychological resilience – the attributes most celebrated in the military’s finest leaders and combat heroes. - Report of the Department of Defense Task Force on Mental Health, June 2007 6. A Proven Treatment Methodology Research/Outcome studies: Much of the literature supporting the burgeoning increase in animal-assisted therapeutic programs is based on case-studies, survey responses, or theoretical literature (Greenwald 2001; Hayden 2005; Iannone, 2003; Root, 2000; Taylor 2001; Tramutt, 2003). Therapeutic riding programs are currently successfully being used by the VA with disabled veterans. EAP has been known to positively affect various groups, e.g. violent offenders, at-risk youth, and people seeking personal growth experiences (Frewin &Gardiner, 2005) and disabled children. At this time, there are approximately 500 centers and programs running in the United States who successfully use EAP for a variety of in- and outpatients with many clinical and psychiatric disorders. 7. Fundamentals of the EAP Model • Specific treatment goals/interventions are identified and documented • Activities captivate and hold attention; they stimulate creativity and “thinking outside the box”: participants learn to rely on resources other than preconceived solutions • Sessions are individually designed; they address prior identified mental health and human development issues quickly, directly and effectively • Activities are designed to incorporate metaphoric learning by recreating situations similar to home, work and in relationships • Due to its nature of being “hands on,” experiential learning and therapy offers the greatest likelihood for authentic participation • Participants create their own internal images, thereby increasing their ability to address psychological material with reduced levels of defenses • EAP stimulates conscious and unconscious processes, creating new possibilities, strengths, perspectives, understanding and solutions • Within attending groups, cohesion deepens and communication is enhanced • EAP sessions are non-directive. This approach benefits participants by:  Allowing opportunity to utilize individual creativity and problem solving  Increasing self discovery, self-confidence, self-efficacy and leadership  Helping participants discover what is right and wrong for themselves  Experiencing the immediate reality of choices, attitudes and consequences • EAP is not a horsemanship workshop: the primary focus is on the development of interrelational, coping and communication skills. • Sessions are conducted on the ground, as well as riding activities. Ground activities are learned first, this allows focusing on skills that need to be addressed instead of focusing on learning to ride. Then when the patient is ready, riding instruction and other physical activities with the horse are taught, such as walking the horse, grooming and other tack steps. • The fundamental concept is that by changing one’s behavior, the environment (here the horses’ behavior) will change. 8. Why horses? Although there are various types of experiential modalities to treatment, horses add an additional benefit. They respond to the participants and their non-verbal messages. Horses – flight animals by nature - are highly social animals living in large herds. Because of that, they have the inate ability to read body language and to respond to underlying issues in large groups. Since horses have no inhibitions, preconceived notions or hidden agendas, they act purely on basic needs, mirroring the behaviors and emotions of the individuals with whom they interact. As a result, the horses “play out” and mirror the dynamics the participants experience in other aspects of their lives. People typically “speak” for animals and are readily willing to interpret animal behavior. These dynamics create unlimited potential for treating a variety of psychosocial problems. 9. Treatment plan: Leaning on the already established Battlemind Training, key concepts of reintegration and stress management are addressed:  Anger management (Accountability vs. Controlling; Targeted vs. Inappropriate Aggression; Non-defensive vs. Aggressive driving; Discipline and Ordering vs. Conflict)  Problem solving styles (Tactical Awareness vs. Hypervigilance; Individual Responsibility vs. Guilt; The Alcohol transition)  Communication (Buddies vs Withdrawal; Mission openess vs. Secretiveness)  Relationship and family roles (Emotional Control vs. Detachment) 10. Training modules/activities: One example of an EAP session in treating redeployment transition issues. Participants are asked to build two spaces utilizing various props in an arena setting; one space represents their time being deployed, the second home or life in garrison. What they build and the meaning behind it will be discussed prior to handling the horses. For example, the props may represent physical and emotional reminders of their deployment and can be labeled accordingly. The soldiers are then asked to move a group of horses from the home space to the deployment space and back. This in itself presents them with a number of difficulties. Horses have different personalities, generally do not want to get separated from each other or might not want to be brought to a certain area. Participants are not allowed to touch or bribe the horses in any manner. How the soldiers go about this activity – which horses they pick, how they communicate with each other, how they work together as a team or individually, how they treat the horses - each aspect of this process and the horses’ responses to their choices is then discussed and related to parallels in their transition experience. The soldiers will determine what metaphor the horses become for them: the horses may become a representation of themselves or family members, or they may represent feelings, beliefs, expectations, or dreams and hopes. By creating an experience like this, the soldiers have the opportunity to project on to the horses and experience real-life concerns, patterns, and beliefs. By addressing the metaphors, the activity itself and experienced difficulties, participants have the opportunity to draw parallels to how they react in similar situations with similar difficulties. The concept of how changing one’s behavior will affect the entire process becomes apparent and can then easily be transferred to their redeployment experience. 11. Assessment tools To be able to measure the efficacy of our program, a series of questionnaires and inventories will be administered before and after the course of these sessions. These test instruments will include proven test instruments about depression, anxiety, PTSD, coping and communication skills. Sessions will be geared and structured to address the most predominant needs of participants. All sessions are monitered by a licensed psychiatrist and with equine staff that have psychology backgrounds/knowledge so that the instructor and staff can worked cohesively to best serve the client. For our pilot program, Psychiatrist Dr. Ron Turco has agreed to volunteer his time to over the progress of these vets and document their progression every step of the way. 12. Providers Providers for Equine Assisted Psychotherapy services are NARHA certified to ensure training, ongoing training requirements for certification renewal, and adherence to standards of ethics and practice. EAP requires sessions to be conducted with a licensed mental health professional working with an equine specialist. 13. Location Many military bases already house horses and arena facilities. Currently, these are primarily used for recreational purposes. However, putting these resources to additional benefit to train soldiers and their families makes financial and investment sense. Additionally, NARHA certified members around the world have facilities and programs in place to provide services in other areas. BEAT is one such place. And with the addition/completion of the Round Pen (in 2008) it gives BEAT two arenas with which to conduct instruction. 14. Sustainability The pilot program has been funded for one year and is now in its second year of the two year program, it is our hope that once people see the tremendous progress and good work made by these veteran’s (that will be documented by Dr. Ron Turco) it will inspire other organizations to get on board supporting the program. Including but not limited to: Veteran’s groups, businesses that support veterans consent to providing more services for their patients via the equine therapy. We believe this is not an unrealistic expectation as our personal experience with running the program for disabled children has done just that. For example, the first year we asked for grant support (in 2005) we only received $8,000, however, last year we received over $42,000 that is a 500 percent increase in only five years! Hence, it is not only possible but plausible. Virtually every organization that has come out to our facility and seen firsthand what marvelous results are produced by the equine therapy here have turned around and given financial support to the program. For this reason, we will be holding regularly an open house invitation to organizations and businesses we pitch the program too. Because we find that the more involved the funder is, the greater the support. As one would expect, funders like to see that their dollars are making a difference, and with this policy in place, they would be able to do just that. In addition, once we have the documented period completed we could apply for federal and state funds. And to start our third year, because we will not be paying for Dr. Turco’s time, we will already have $15,360 set aside for the program. (We listed the cost with the consultation inside to be able to pay for the services after Dr. Turco is done completing the pilot trial program. And in the event if something unforeseen should happen in the next two years, such as death, etc. that would make him unable to complete the program.) In addition, once the efficacy of the equine therapy has been demonstrated to be a successful treatment modality for treating PTSD in Oregon, (after the two yr pilot program is complete) we will not need to spend anywhere near the amount of money we will require for start up and initial evaluations and monitoring progress of each patient. Their care/progress should be able to be screened and followed by monthly visits, not daily/weekly thereafter. We also plan to execute a revolving door of solicitations for funds from various foundations and businesses. With this plan in place, no one organization or business would be asked to contribute any more than once every 3- 5 years. We would send out proposals to a list of funders that would be level one, then the following year a second bunch and the third year the same. Last but not least, it should be noted that BEAT has maintained an excellent equine therapy program for the last 15 years now and has continued to grow and expand their services throughout over a decade of community service. We have gone from helping a handful of kids each week to over 60 now. But our facility is not at capacity which means we can still grow comfortably with the resources we already have. A new organization just starting out would need to find a place that could accommodate them. Since the completion of the round pen two years ago that is fully covered and handicapped accessible, we are able to handle over 100 people each week regardless of weather and accessibility requirements. And because the round pen is already handicap accessible, any veterans needing wheelchair accessibility will have no problems being served in BEAT’s round pen area. Also, it should be noted that our veteran volunteer who first suggested this plan to us, said that as a volunteer with the Portland VA, he could get us all the volunteers we’d need to help in running the pilot. So that is an added in-kind bonus. In conclusion, if need be, BEAT will do as it has done for its ongoing program for kids, we’ll host a fundraiser specifically for the veterans program. And just as the community has continued to support BEAT for the last 15 years, we are confident they will embrace our new program. BEAT regularly hosts over six to eight fundraisers each year. Running another one would like routine. 15. Our Board: We have a five member board that is as dedicated to the B.E.A.T. program as the original founders. Charlene Bechen – Secretary – 42370 NW Lookover Dr., Banks, OR 97106, Ph: 503/324-1710 Rhondi Jones – President – 16690 SW Highhill Ln., Aloha, OR 97007, Ph: 503/590-2840 Wendy Wilson – Treasurer- 19640 SW Trelene St., Aloha, OR 97007, Ph: 503/649-3803 Dawn Glass – Board Member – 1392 NE Oleander Ln., Hillsboro, OR 97124 Robin B. Fabrao-Rosebalm – Board Member- 4130 SW 117th Ave., Beaverton, OR 97005 16. References: There are currently programs around the country providing EAGALA model EAP services for military personnel, veterans, and their families. These programs provide services for treatment needs including deployment transition issues, PTSD, alcohol and chemical dependencies, abuse, grief, and marital and family therapy. For more information, contact the BEAT Riding Center.