Qualified to Heal

Assessment of Data/ Program Evaluation

Dr. Richard Tedeschi and Dr. Bret Moore

The data to date support Boulder Crest’s belief that Warrior PATHH is improving the psychological health of veterans battling posttraumatic stress disorder and other psychiatric conditions. Results from traditional clinical self-report measures (e.g., PTSD Checklist for DSM- 5, Depression Anxiety Stress Scale-21, Insomnia Severity Index) embedded within the program evaluation reveal robust improvements in clinical symptoms. Moreover, these improvements are consistent with improvements seen in traditional outpatient healthcare systems (e.g., VA clinics), and in some cases, surpass these same metrics.

The same is true for depression, anxiety, and stress. At eighteen months after completion of Warrior PATHH, participants show sustained improvements of 50% for depression, 45% for anxiety, and 40% for overall stress. Clinically significant improvements are also seen for insomnia with a 40% reduction in sleep disturbances eighteen months following completion of Warrior PATHH. Results also reveal that veterans are showing substantial increases in developing and maintaining positive emotions (e.g., joy, inspiration, pride) while reducing negative emotions (e.g., guilt, irritability, nervousness).

A unique aspect of Boulder Crest’s Warrior PATHH program is the emphasis on teaching veterans to live well and how to use their difficult life and combat experiences to thrive. After completion of Warrior PATHH, the data reveal that veterans are better able to effectively manage a variety of life stressors, develop a greater flexibility and adaptability in order to more effectively manage life’s adversities, and foster healthier interpersonal relationships.

“THE DATA ALSO SUPPORTS THE MAIN PURPOSE OF WARRIOR PATHH, WHICH IS TO PROMOTE POSTTRAUMATIC GROWTH. WARRIOR PATHH PARTICIPANTS REPORT AN INCREASE IN PERSONAL STRENGTH BY 42%, IMPROVED RELATIONSHIPS BY 40%, AND POSITIVE SPIRITUAL/EXISTENTIAL CHANGES BY 58%. ON AVERAGE, PERSONAL GROWTH OVER THE EIGHTEEN MONTHS FOLLOWING THE WARRIOR PATHH PROGRAM IS 40%.”

Due to the fact that traditional veteran mental healthcare systems do not measure psychological growth on a routine basis, it is difficult to make any direct comparisons. However, based on research in the civilian population, these changes are impressive and Boulder Crest should be commended for addressing this aspect of veteran psychological health and their success in promoting it in those who complete the program.

We believe there are several therapeutic processes within the Warrior PATHH program that lead to the identified improvements in clinical symptoms, stress management, and psychological growth. First, Boulder Crest and Warrior PATHH staff create a respectful, empathic, and non-judgmental atmosphere which promotes personal reflection, self-disclosure, and connection with others. The relationship that Boulder Crest staff builds with participants is similar to the relationship that is formed in psychotherapy, which, according to “common factors theory,” is believed to be the most important factor in all effective psychotherapies.

Second, Warrior PATHH incorporates practices which have been shown in clinical research to be effective for a variety of populations and conditions. A few examples include meditation and mindfulness, psycho education, stress management, and self-disclosure. Moreover, the program includes a variety of wellness practices that are based in science found within the areas of recreational therapy, nutrition, and physical fitness. And last, unlike traditional mental health models, Boulder Crest provides substantial aftercare as part of their 18 month follow-up program.

Although reducing clinical symptoms (low mood, hyperarousal, nightmares) is important, the reality is that even after successful treatment with psychotherapy and/or medication, symptoms will continue for many. This narrow and reductionistic approach to psychological health lessens the likelihood that growth will occur and increases the likelihood that the veteran will need to accept a diminished version of themselves. We believe this does little to honor the sacrifices of veterans and embraces a “good enough” mentality when it comes to caring for the men and women who have served our Nation.