Proposing a Patient-Centered Approach to Understanding TBI Outcomes Through a Trauma Informed Research Design Evaluating Mental Health Treatment Histories

Session Description: Mental health plays a major role in recovery from mild traumatic brain injury (mTBI) and is a key predictor of long-term functioning. One-third of active duty service members (ADSMs) receiving the military’s top-tier traumatic brain injury (TBI) treatment do not report symptom improvement. The Department of Defense (DoD) TBI treatment pathway does not implement clinical practice guidelines for posttraumatic stress disorder (PTSD) nor is trauma-informed care a standard part of TBI treatment practices. To what extent the lack of focus on PTSD within the TBI treatment pathways has, and continues to, impact outcomes is unknown; but also potentially underestimated. A recent study showed service members in treatment only received on average 2.5 psychotherapy appointments per quarter, substantially below standard of care dose for mental health work, especially the therapeutic alliance needed for trauma processing.
We will present our multi-site study. Using a mixed-methods design, we aim to examine mTBI treatment outcomes by comprehensively gathering psychological trauma and mental health treatment histories of ADSMs. We will discuss the development of a novel measure that will capture histories and perceptions of treatment through a structured interview. We will also review the effectiveness of current and future treatment practices including the use of psychedelic assisted therapy. This study intends to yield actionable knowledge to improve mTBI rehabilitation, psychological health care, and military operational readiness. This project is a call to action for collaboration, research, and advancing care strategies to better serve those who serve our nation. Suicide in the military and specifically in the Special Operations Forces (SOF) community is a major concern with ripple effects impacting so many. Core to the topic of suicide prevention is adequate mental health treatment, highly relevant for SOF who are at increased risk for TBI and can experience PTSD symptoms at higher rates than conventional forces.