Therapists Use Internet to Treat Reluctant Veterans
To survive in war, you have to get into a certain mindset. Trouble is, when you come back, it's hard to get out of it.
MONTES: I was just overwhelmed with the normalcy. Everything is normal here, like, you know, the buildings are still in tact, there's nothing on fire.
Angel Montes returned three years ago from stints in Baghdad and Fallujah. He was having a hard time sorting out his feelings. Or even the idea of feelings.
MONTES: The only feelings that I was capable of knowing I felt was anger, or happy, or…that's pretty much it.
He tried to settle back into life with his wife and kid, but things weren't the same.
MONTES: In the military we're really rough with each other, especially if you've been deployed for a long time. I felt like, sort of like an animal with human beings, trying to relate to them.
Montes eventually did get help, though it took his wife putting her foot down. He's what psychologist Eric Proescher calls a reluctant help-seeker.
PROESCHER: I don't care how much the leadership says look, it's OK to have mental health problems. There are so many other messages that undo that in our culture, that whatever our industry has done to destigmatize it, I don't think it's been very effective.
So there are a couple problems: diagnosing vets without embarrassing them, and getting people from a macho culture to deal with their emotions. To reach an elusive, young, mostly male population, mental health professionals are doing the same thing advertisers and recruiters do: they're going on the internet.
Vets Prevail is an internet-based platform for cognitive behavioral therapy. Just don't call it therapy.
COMPUTER: Every bit of training helped you survive the experience that made you a veteran. Here's even more valuable training that can help you better survive, and manage the impact of that experience.
MONTES: I know what training is, so I would respond better to that word than, I'm fragile and blah blah blah, and I need therapy.
The whole program uses the vernacular of veterans. Symptoms aren't “treated,” they're “targeted.” It was developed by the Chicago startup, Prevail Health Solutions, working with veterans like Montes and clinicians like Proescher. The vets can use it at home without worrying about being spotted in a therapist's office, and they can log in at two in the morning when they're up with insomnia. Montes clicks his way through a typical intervention
COMPUTER: We sometimes see physical symptoms first. Check the boxes for symptoms you or…
MONTES: Clenching jaws, sleep problems, weight loss or gain…
The narrator talks about stress, readjustment, it's all very buddy-buddy. As Angel listens, photos and illustrations roll across the screen. He likes that there aren't a lot of quick cuts – frenetic images make him tense. Between the explanations are stories of relatable vets.
COMPUTER: All the stress got to me so bad I was just exhausted. So exhausted I just wanted to sleep. Sometimes I'd get all anxious and just lay in bed watching TV and lose complete track of time...
The program guides vets through activities to cope. Studies have shown these computer-based therapies can help with anxiety and depression, though this is thought to be the first one designed for veterans. Prevail is planning clinical trials this summer, and they got money from the National Science Foundation to run focus groups.
Eight Iraq and Afghanistan veterans have just gone through the intervention. Now they're lounging on couches with snacks and sodas, talking over they're impressions with psychologist Bill Sallas.
SALLAS: Anything else?
PARTICIPANT: I thought it was really down to earth.
The vets seem to agree the program does a good job of speaking their language. They connect with that idea of “retraining.” But the focus group also reveals some limitations.
PARTICIPANT: If you see one of your friends get blown up or someone gets shot, you're not gonna be looking on the internet for answers. You're gonna need someone to come up to you and tell you, 'Hey, you're doing this, you're doing that, you're not thinking right.' Cause you might not even know you have a problem.
In the next year or so, troops are expected to come home by the tens of thousands. If statistics hold up, at least one in four will have to cope with some kind of mental health problem. The vets here say this program is at least an attempt to cope with modern warfare, using modern methods.