Robert Shulman, MD: The Road Home Provides Highly Effective, Immersive, Data-Driven Programs

The Road Home program is our Center for Excellence and treatment for veterans and their families. We have several different forms of treatment for different conditions. We sponsor ongoing therapies, regular psychotherapies, and counseling for either the veterans, or their families, family members, in fact. And it may even be for non-military kinds of reasons for families as such. We will just provide that care. And the care is provided at little to no cost. If they have insurance, we’ll bill insurance, but otherwise they just need to qualify as being connected to the veteran. We also will do medication management for veterans that are here in the Chicago area, and we can provide ongoing care for. And then we sponsor are these intensive outpatient programs where veterans can come in from all over the country or beyond. As long as they qualify and go through the screening process and have post-traumatic stress disorder or are survivors of military sexual trauma. So we have two treatment arms, one is the sort of battlefield PTSD and then on the other hand, we provide treatment for the survivors of military sexual trauma. And they’ll come in for two weeks, they’re put up in housing close by and from dawn to dusk will attend treatment in our program, our center. We provide, cover the expenses of this through the wonderful help of our patrons and our donors, the Wounded Warrior network, Warrior Care network being the primary philanthropic contributor to our program. And patients will go through these two-week intense outpatient program. We started with three weeks. We found that the two-week data is almost just about as good. And that we’re able to provide this intensive treatment over two weeks’ time such that we see a reduction in rating scores for - a reduction of symptoms as reflected in the rating scores. And then the person returns home. We work very hard to find follow-up in their areas and/or maintain some sort of connection to them if we’re able to. And that’s what the program is. It really is a mission-driven program, and the mission is to provide really leading cutting edge data supported treatment to veterans and their families, those who really sacrificed so much. The neat part about it, being at the university, that appeals to us is that we’re able to collect data and really show the value of what we do. We can reduce trauma rating scores significantly. People not only feel better, we reduce the risk of suicide. But what else happens? They go home, they’re part of systems, whether it’s family, social systems, work systems, the productivity is improved. So, every vet that we treat we feel that there is a societal benefit for. I mean, if you talk about making contributions and taking care of people and such, treating trauma, whether it’s veterans or in the inner city, with children and such, this is where you can get a tremendous bang for the buck. And I think our data is showing it and will continue to show it as we develop these programs further and take them beyond the military. And that’s our mission here at Rush. It’s a form of cognitive behavioral therapy where you open up. What was the event, you discuss the event, and what was the emotional response to the event and how has it continued to affect you and what triggers do you have for it and what thoughts do you have and what are your automatic feelings associated with the thoughts? And then you work with the person to sort of address the thoughts and the feelings that come with it. So “Okay, when this happened, this was your response in Afghanistan. Now that you’re back home, when your partner says this or does this or the kids make a big noise, this is your response. How can you work through it better, how can you change?” And you actually practice exercises in changing things, and you try and help the person formulate it, so they’re not stuck in the same thoughts. So they don't go back to battle or back to the traumatic event with the trigger, that they can teach themselves to go somewhere else and then calm themselves. It’s a form of cognitive behavioral therapy, CBT, but it’s something really specific with specific techniques that the therapist employs. But we felt it really important to take more of a comprehensive approach and not just a medication approach. And so we developed the program and over the last four or five years it’s evolved. We can actually speed things up in some ways. We’ve learned by getting feedback from our patients as to what helped them most, how did they feel about this aspect of treatment, how did they feel about the mindfulness. How did they feel about the art therapy they received or the music therapy, different aspects of the program? We learned what parts of our screening tool gave us the best data and the most exact data, what part of our screening tools actually were significant, which questions were most significant than others, which questions actually correlated with diagnosis and with responses and such. So we’ve learned an awful lot about treating PTSD. We did not have the sexual trauma survivor program at first and we instituted that. We’ve learned as we have gone. That we try and incorporate the strongest aspects as we decrease the time investment and we really try to focus on the strongest aspects of treatment, the things that give us the most bang for the buck, the most responses, we’ve developed a program the way it is now. 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