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Through grant, Seton expands intensive PTSD program to veterans

Austin American-Statesman - 7/21/2019

Kat Harper tried to keep going after she says she was sexually assaulted by a fellow soldier while serving in the Army. Harper was 19 at the time and in training to be a nurse; she thinks someone put something in her drink at a barracks party she and her classmates weren't supposed to be having.

"I was embarrassed and scared," said the now 32-year-old Harper. She didn't report it right away. Harper said she did a few weeks later: "How I was treated by classmates and leadership was worse than what actually happened."

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She served for eight years active duty and then reserve, and took care of fellow soldiers at Army hospitals, but she wasn't taking care of herself. She drank too much alcohol and was not able to work.

"I couldn't handle any of it anymore," Harper said. She was diagnosed with post-traumatic stress disorder and given 80% disability. Therapy through Veterans Affairs has helped some, but a new program at Ascension Seton has made the biggest difference in her life.

The Veterans Restore Program is a six-week intensive outpatient therapy program for veterans who have PTSD. Ascension Seton also has a Restore Program for non-veterans, but this year it has a grant through the Texas Veterans and Family Alliance program that allows it to offer the program to veterans for free.

Typically the program would cost $7,000, which many insurance policies will cover, but the grant allows participants to not pay co-pays or have to wait for insurance approval. The grant also covers transportation to and from the program each day if it is needed.

For the veterans program, the trauma does not have to be combat-related, and they don't have to have an honorable discharge. Groups usually include about 12 people, with veterans of all ages.

The Veterans Restore Program began just this year, and the civilian program has been going since 2017.

"Fifty percent come to the program and completely lose their diagnosis," said Dr. Valerie Rosen, a psychiatrist who heads both programs. "They leave without PTSD."

For the other half, their symptoms are lessened, Rosen said.

She had experience working with the VA as well as working with victims of sexual assault at Yale University. Before she started using the techniques used in the Restore program, she used different therapy techniques that weren't as holistic or intensive.

"I worked with a lot of veterans and had great relationships with them, but nothing changed," she said. Then she tried the techniques used in the Restore program with a patient who had PTSD from his time in the Vietnam War."He lost his diagnosis," she said. "He thought PTSD was lifelong, and there was not a lot you can do." That is not the case, she said.

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Ascension Seton uses an assessment process to make sure Veterans Restore participants do have PTSD and are ready for treatment. Often clients are convinced they need the treatment or a loved one has decided they need it, Rosen said. Organizations that connect veterans to the Restore Program include the VA, as well as places that do outreach to veterans, such as the Samaritan Center.

Sometimes it's a hard sell. "People tend to try to blame themselves when something bad has happened," she said. "It's the illusion of control. They feel guilt, shame or blame."

During the six-week program, attendees come four days a week for three hours a day -- and there is homework. The program includes cognitive processing therapy to examine the reality of the event and look at distorted thinking clients might have. It also includes trauma-sensitive yoga, dialectical behavior therapy to tolerate difficult emotions, and resilience training.

Yoga helps because "it's retraining the mind and retraining the body," Rosen said. People who have trauma can have a fight-or-flight response, she said. "Yoga allows them to regain control."

Harper had learned much of the concepts in other therapies through the VA, but putting them into practice was different, she said. "I was extremely impressed with how they pulled in those concepts into real life."

During the six weeks, the members of the group stay the same, and they go on outings to learn how to be out in the world again.

"Early in therapy, I was having agoraphobia," Harper said. "Stores were overwhelming."

Group members take field trips to the Blanton Museum of Art, where Ray Williams, an educator there, helps them look at art through some of the same tools they use to look at their trauma. The Blanton is also good training for being in public, and it's a place where veterans can get in for free to continue practicing.

"The main goal is for them to be safe to be in a public place," Rosen said.

They also do horse therapy through Healing with Horses Ranch. Horses are prey animals and they have a strong startle response, Rosen said.

"They are very in-tune with human emotions," she said. Participants have to use their skills to remain calm or the horses won't want to be around them.

The group helped Harper in many other ways. She had not been in a class with men since she was in the Army. She didn't think she could, which was part of the black-and-white thinking she experienced that the program helped her challenge.

"It was really helpful to get over that," Harper said. "I was having to face what I'm afraid of and not expect the worse from people."

She also didn't think the men in her group would support her because her trauma was not combat-related. They did. "They made me feel OK about it," she said. "They helped me accept it."

Harper said she learned a lot about herself, especially that she felt a need to always put others first and that her self-esteem was low. "I still have bad days, but for the most part it's much better," she said. She now feels more in control and less impulsive.

Rosen said participants find that their sleep improves and their nightmares go away or are reduced. "They get confidence in themselves again and feel more calm and comfortable in their body," she said.

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