WVSJ Network: What are Some of DoD's Specialized Care Programs for Chronic Illnesses and PTSD?

Specialized Care Program (SCP) Track I

What Is It?

The SCP Track I is an intensive treatment program designed to address persistent disabling symptoms attributed by service members to deployment or other military exposure. It features three-weeks of multidisciplinary treatment of patients in small groups of three to eight individuals.

The program is based upon internationally recognized centers for management of chronic illness. It provides state-of-the-art care for those suffering from multiple symptoms such as:

Fatigue
Headache
Digestive Problems
Weight Gain

Joint Pain
Skin Rash
Memory Problems
Weight Loss

The Program's Goals

Improve conditioning and decrease symptoms via a gradual, paced physical reactivation program.

Provide opportunities to improve work performance and other activities of daily living.

Promote overall well-being, symptom reduction, improved coping and decreased healthcare utilization through the practice of positive health behaviors and skills.

Actively involve each participant in creating an individualized symptom management plan.

What Type of Care Is Provided?

The Specialized Care Program is designed to meet each participant's needs at a variety of levels. In addition to treatment of physical symptoms, there are interventions to assist in dealing with the stressors which accompany chronic pain and chronic illness such as loss of former abilities, strain on relationships, and transition from the military.

This program provides carefully coordinated delivery of care that takes into account many medical perspectives.

SCP Track I patients work closely with an internist and a health psychologist. Other members of the health care team include a, physical therapist, nurse, clinical social worker, and a nutritionist. A range of other medical specialists are also available depending on a patient's medical needs.

The Program includes:

A thorough review of medical history and past diagnostic testing with an internist
Education regarding symptoms and personal health care management
Support and education for family members
Group and one-on-one meetings to discuss the impacts of physical symptoms, life stressors, and military experiences
Information regarding benefits for veteran

Who Can Participate?

The SCP Track I is available to members of all armed services and components, as well as to family members affected by persistent symptoms. The Specialized Care Program emphasizes treatment over evaluation.

Prior to admission to the Specialized Care Program, each person's medical record is extensively reviewed by a multidisciplinary team of healthcare professionals. The purpose of this review is to determine whether or not the Specialized Care Program would be an appropriate treatment

What Is the Specialized Care Program SCP Track II?

Intensive, three-week, multi-disciplinary treatment program for patients with deployment-related stress, Post Traumatic Stress Disorder (PTSD) and/or difficulties adjusting to re-deployment

Comprehensive program designed to accommodate a need for treatment of operational stress and PTSD associated with recent combat deployments

Focus on supportive treatment for service members from OEF/OIF with difficulties readjusting upon return who attribute concerns to operational stress or other operational issues and:

Assistance through other treatment venues has been unsuccessful or

Treatment resources at local and specialty care settings under existing standards of care have been exhausted or

Treatment resources at local and specialty care settings are not available to meet the specific treatment needs of the patient and

Patient continues to experiences difficulties in functional status and quality of life.

Designed to prevent chronic PTSD which creates higher usage of medical/behavioral health resources

Designed to reduce co-morbid health concerns such as depression, substance abuse, and domestic violence which contribute to high utilization of healthcare services

What Type of Care Is Provided by the SCP Track II?

Each SCP-Track II treatment plan is designed to meet individual patient needs

An internist evaluates/provides needed medical treatment for physical symptoms

Program teaches patients strategies to deal with the physiological, behavioral, emotional, and cognitive effects of stress/trauma and their resultant consequences on social, occupational, emotional, and interpersonal functioning and quality of life

Treatment program is group oriented, with three to eight individuals going through 3 week program as a group in order to facilitate trust and mutual support

What Are the Key Elements of Care for SCP Track II?

Behavioral health and self-care strategies and treatment modalities including:

Cognitive-behavioral therapy

Group exposure therapy

Physical reactivation

Stress management (relaxation training, massage therapy, yoga and acupuncture)

Educationally-based self-care focus with relapse prevention follow up

Multiple phone call follow up contacts for 10 months with clinician to secure improvements

Functional status emphasis and return to duty

Multi-disciplinary staff (physician, psychologist, social worker, nurse, physical therapist)

Structured, day-hospital milieu, 0730 - 1600 for three weeks, Mon.- Fri.

Ease of access to other referral sources within the Walter Reed National Military Medical Center (WRNMMC) system

How Are People Referred to the Program?

Military health system clinicians can refer patients meeting admission criteria to the program

Patients must be ambulatory and capable of some exercise

Patients musts be stable enough for independent functioning

Referral must include evaluation by a mental health professional to rule out significant co-morbid mental illness, e.g., psychosis, suicidality, active substance abuse