1. The impact of war on the individual is profound. War is “bad for your brain”. No one returns from deployment the same. The “consequences of war” are exacerbated as deployments increase.

2. Prevalence of TBI & PTSD in OIF/OEF Soldiers Estimates vary and sampling problems have been identified: TBI: 19.5% of soldiers translating to 320,000 probable TBI cases (95% CI of 16.4% - 22.7%). PTSD: 13.8% of soldiers translating to 226,000 probable PTSD cases (95% CI of 11.1% - 16.5%).

3. mTBI/PTSD SX Overlap M. STEIN ET AL., AM J PSYCHIATRY 166, 7 (JULY 2009)

4. The consequences of war and post-deployment adjustment issues can lead to chronic conditions that impairs the entire person – body, mind & spirit.

5. The “Typical” TBI Clinic Pt The majority of SMs who present to the TBI Clinic suffer from complex biopsychosocial disease including: A) Chronic Pain B) Chronic Insomnia C) Cognitive Weaknesses D) Other Physical Symptoms &/or Medical Conditions E) Depression F) Anxiety G) Some degree of PTSD H) Probable Alteration of Self Concept & Self-Esteem These variables interact & can yield global impairment.

6. TREATMENT * This complex clinical sequelae demands aggressive, integrated interdisciplinary intervention. * Each area of difficulty must be addressed. * Because SXs interact, improvement in one area can have carry-over effects.

7. Fort Hood TBI Clinic Numerous Services are Available Primary Care Medical Management Acupuncture Biofeedback Chiropractic Clinical Pharmacy Education Psychotherapy Massage Therapy NCM Occupational Therapy Physiatry Physical Therapy Speech Therapy

8. Fort Hood TBI Clinic Intensive Outpatient Program The SM’s Command signs-off on participation. Duty station for 6-weeks. 0800 – 1600 5 days per-week. Each cohort includes 6 SMs. Group & Individual Sessions. Longitudinal Mutivariate Research Design.

9. Intrepid Spirit/ Intrepid Spirit/NICoE