Abstract ID: 3901

Primary Topic: Integrative medicine delivery models
Secondary Topic: Mind-body (including meditation and yoga)

Utilization of Integrative Medicine in an Interdisciplinary Intensive Outpatient Program for Service Members with Combat-Related TBI and Psychological Health Conditions
Manoj Bhasin, PhD, Beth Israel Deaconess Medical Center, Boston, MA, United States; Thomas J DeGraba, MD; Melissa Walker, MA, Walter Reed National Military Medical Center, Bethesda, MD, United States

Late Breaker: No

Overview

Combat operations and training injuries have resulted in traumatic brain injury in over 370,000 service members (SM) since 2001. The occurrence of behavioral health comorbidities in up to 40% of these SM presents the need for novel treatment paradigms to address persistent symptoms. The National Intrepid Center of Excellence (NICoE) developed a 4-week interdisciplinary, holistic patient- and family-centric intensive outpatient program (IOP) utilizing conventional and integrative medicine treatments to place SM on a trajectory of recovery.

In an attempt to characterize the injury and response to the implementation of the Arts and other mind-body techniques in the care of these service members, a multi-modal assessment approach including genomics is used. This symposium will address:

1) The interdisciplinary integrative care model in the Military Health System and will include the description of the intensive outpatient program (IOP) used at NICoE as well as mind-body techniques used in the TBI Pathway of Care Network (10 minutes)

2) The use of creative arts therapies (art, music, dance/movement, and drama) as integrated components of behavioral health assessment of SM and as treatment strategies for ongoing recovery (30 minutes)

3) The effects of the integrative care model on physiological parameters including brain wave patterns measured by magnetoencephalography (MEG) and autonomic patterns as measures by TCD derive cerebral vasomotor reactivity metrics (20 min)

4) Studying effect NICoE intervention on genomics landscape of SM to identify key molecular pathways associated with healing and further their association with the neurological and behavioral response to treatment (20 min).

Rationale

Combat operations and training injuries have resulted in traumatic brain injury in over 370,000 service members (SM) since 2001. The occurrence of behavioral health comorbidities in up to 40% of these SM presents the need for novel treatment paradigms to address persistent symptoms. The National Intrepid Center of Excellence (NICoE) developed a 4-week interdisciplinary, holistic patient- and family-centric intensive outpatient program (IOP) utilizing conventional and integrative medicine treatments to place SM on a trajectory of recovery.

Objectives

In an attempt to characterize the injury and response to the implementation of the Arts and other mind-body techniques in the care of these service members, a multi-modal assessment approach including genomics is used. This symposium will address:

1) The interdisciplinary integrative care model in the Military Health System and will include the description of the intensive outpatient program (IOP) used at NICoE as well as mind-body techniques used in the TBI Pathway of Care Network (10 minutes)

2) The use of creative arts therapies (art, music, dance/movement, and drama) as integrated components of behavioral health assessment of SM and as treatment strategies for ongoing recovery (30 minutes)

3) The effects of the integrative care model on physiological parameters including brain wave patterns measured by magnetoencephalography (MEG) and autonomic patterns as measures by TCD derive cerebral vasomotor reactivity metrics (20 min)

4) Studying effect NICoE intervention on genomics landscape of SM to identify key molecular pathways associated with healing and further their association with the neurological and behavioral response to treatment (20 min)

Methods/Session Format

Overview by Thomas J. DeGraba, M.D. (10 minutes)
The interdisciplinary integrative care model in the Military Health System and will include the description of the intensive outpatient program (IOP) used at NICoE as well as mind-body techniques used in the TBI Pathway of Care Network 

Session 1: Melissa Walker, MA (30 minutes): Melissa developed and implemented the NICoE Healing Arts Program to explore the integration and research of the creative arts therapies for service members with traumatic brain injury and psychological health concerns. Melissa also acts as lead art therapist for Creative Forces: the NEA/Military Healing Arts Network - a collaboration aimed to expand arts access for the military population. Since its inception the NICoE's art therapy program has gained international recognition, including a National Geographic Magazine cover story and Melissa's TEDMED talk featured as TED's "talk of the day."

She will be talking about use of creative arts therapies (art, music, dance/movement, and drama) as integrated components of behavioral health assessment of SM and as treatment strategies for ongoing recovery 

Session 2: Thomas DeGraba,MD (20 minutes). Dr DeGraba is a Neurologist and Acting National Director of the Defense and Veterans Brain Injury Center and Chief Innovation Officer at the National intrepid Center of Excellence. ‎Dr. DeGraba has been engaged in care of Service members with combat-related TBI and psychological health condition at Bethesda Naval Medical Center / Walter Reed National Military Medical Center for over 15 years. He is engaged in research that assesses the interdisciplinary integrative intensive outpatient care and measures electrophysiologic, autonomic and genetic patterns in disease and recovery state. He will be talking about effects of the integrative care model on physiological parameters including brain wave patterns measured by magnetoencephalography (MEG) and autonomic patterns as measures by TCD derive cerebral vasomotor reactivity metrics

Session 3: Manoj K. Bhasin (20 minutes) Dr. Bhasin is an Assistant Professor of Medicine at Harvard Medical School (HMS) and Director of Bioinformatics and Systems Biology at Beth Israel Deaconess Medical Center (BIDMC) (Boston, MA, USA). He is also a co-Director of BIDMC, Genomics, Proteomics, Bioinformatics and Systems Biology Center and Senior Investigator at HMS Vascular Biology Center. He is also Associate Senior investigator at Benson-Henry Institute for Mind Body Medicine in Boston. He adopted innovative Genomics and systems biology approaches used to understand the mechanism of mind-body medicine practices and integrative medicine more broadly. In this symposium, he will present overview of studying effect NICoE intervention on genomics landscape of SM to identify key molecular pathways associated with healing and further their association with the neurological and behavioral response to treatment.  

Outline

1) The interdisciplinary integrative care model in the Military Health System and will include the description of the intensive outpatient program (IOP) used at NICoE as well as mind-body techniques used in the TBI Pathway of Care Network

2) The use of creative arts therapies (art, music, dance/movement, and drama) as integrated components of behavioral health assessment of SM.

3) The effects of the integrative care model on physiological parameters including brain wave patterns measured by magnetoencephalography (MEG) and autonomic patterns as measures by TCD derive cerebral vasomotor reactivity metrics 

4) Studying effect NICoE intervention on genomics landscape of SM to identify key molecular pathways associated with healing.