PHP for Active Duty Service Members Includes Art Therapy

News | Aug. 15, 2024

Walter Reed Offers Partial Hospitalization Program for Mental Health Care

By Bernard Little

Walter Reed National Military Medical Center, BETHESDA, Md  –  

Walter Reed offers the Partial Hospitalization Program (PHP), providing support and skills to assist people in managing their behavioral health challenges while living at home.

The program offers a structured treatment setting with a scheduled list of activities during the day, and participants returning to their homes at night, explained Navy Lt. (Dr.) Meghan Quinn, a psychiatrist, PHP chief and assistant chief of Navy Graduate Medical Education at Walter Reed.

PHP patients have no acute safety risk for themselves or others, Quinn explained. They can function at a higher level when they stay in contact with their loved ones (not housed separately or isolated) and patients like it. They can see their partners, kids, pets and others on a daily basis, which is beneficial to their recovery and treatment, she added.

The program began at Walter Reed Army Medical Center (WRAMC) and transferred to Bethesda, now Walter Reed National Military Medical Center, following (Base Realignment and Closure) BRAC and WRAMC’s closure in 2011.

During the COVID-19 pandemic, the program experienced a reduction in hours, but last year, it resumed its hours prior to the pandemic. PHP is now celebrating its one-year anniversary of comprehensive trauma and general mental health treatment provided to active-duty service members, said Quinn. She added that nearly 300 patients have received this care during the last year.

The PHP at Walter Reed is a full-day program, with patients coming here as their place of duty with command approval. There is great benefit in staying in military spaces, Quinn explained. Regular communication with the patient’s command and outpatient treatment team on their progress can include fitness for duty recommendations with an eye on military standards and goals of both patients and their command.

Quinn explained the structured program is four or five weeks “The content builds so you can start at any point and not wait,” she said. There is generally a technician-led group first thing in the morning, and one closed group each day where patients and staff can address heavier topics, such as coping with suicidal thoughts.

There is a final optional group most days that patients can “wind down depending on what [kind of] day it’s been,” Quinn said.

“[The PHP] has the capacity to treat up to 40 patients at one time,” said Quinn. “We try to keep the ratio manageable so groups don’t get too big, and everyone can participate.” She went on to describe how patients are divided into two separate treatment programs upon intake. The Comprehensive Recovery Program (CRP) focuses more on general mental health topics, and the Trauma Recovery Program (TRP) helps patients process traumas that have occurred at any point in their lives that are impacting their current functioning now. These treatment programs may be split into smaller cohorts at times based on type of trauma, or other factors.

In addition to Quinn, core staff for the PHP includes 10 primary therapists (four psychologists, six social workers, an art therapist, two psychiatrists, a nurse practitioner. “The staff here are fantastic. They have a lot of experience working with military patients and their specific concerns.” She added most are former military or spouses of service members. Rotating trainees include one psychiatry resident, and at times, medical students, 66C (psychiatric nursing) students, and Interservice Physician Assistant Program (IPAP) students.

All patients receive formal art therapy once a week and participate in trips outside of Bldg. 85T at Walter Reed, the current home of the PHP.

“We have had a few recreational activities. We’ve been to the zoo, have gone rock climbing in Rockville, Maryland, to Great Falls, Virginia and to Brookside Gardens, Maryland,” Quinn said.

There is also horticulture therapy, and Quinn added that a therapist also arranges for patients to receive regular visits from Walter Reed’s facility dogs.

“All of our patients see their prescriber weekly for medication management, in addition to having two individual therapy sessions most weeks,” Quinn added. “We meet as a clinic team once a week to discuss the progress and clinical condition of every patient in the PHP, so we are able to truly give a comprehensive overview of their status and treatment.

Quinn explained that there has been a stigma about people seeking help for mental health care, particularly service members, fearing the impact it may have on their careers. “People in the military are often hesitant to try [therapy] but here [to provide the] best mental health [care].”

According to a 2006 study in Military Medicine, 97 percent of service members who seek mental health treatment do not experience any negative career impact. In addition, seeking mental or behavioral services will not affect a service member’s security clearance (https://tricare.mil/PatientResources/MediaCenter/TRICARE-Videos/Will-Mental-Health-Services-Affect-My-Security-Clearance#:~:text=The%20short%20answer%20is%3A%20No.)

Quinn added that the PHP includes a number of adjunctive therapies, including Transcranial Magnetic Stimulation (TMS), which she collaborates with Dr. Vanessa Torres-Llenza to tailor these therapies for patients. TMS uses magnetic pulses directed toward the brain to treat severe depression or anxiety, Quinn shared.

Another adjunctive therapy used in the PHP is battlefield acupuncture, in which five tiny, sterile needles are placed on a patient’s ear, which simply fall off after a short time. “It was originally [used] for pain and insomnia and is a great adjunctive therapy where depression decreases,” Quinn explained.

The program has also experienced positive outcomes with Alpha Stimulation, which helps with chronic pain and insomnia, and assists patients with relaxation, Quinn explained.

Quinn added that the PHP has a memorandum of understanding (MOU) with Building 62 at Walter Reed to house patients who come from long distances, since this is the only PHP of its kind in the National Capital Region (NCR). “We meet that need, and [patients can] stay when commands [elsewhere] don’t have access [to a PHP program].”

“We are always looking at ways to adapt the program to meet the needs of our current patients and monitor trends in referrals,” said Quinn. She explained that this has led to incorporating trauma treatment into the general mental health program, including adding eye movement desensitization and reprocessing for post-traumatic stress. 

“[We would like to] have information on the program spread,” Quinn said. “We have resources to work and connect with them. [We love how] patients talk to each other and get referrals. Somebody in your company was here and now word [about this PHP] is making its way around.”

She said that nearly every rank, including enlisted personnel up to E-9 and officers up to O-6, have taken advantage of the PHP. “This is the only adult PHP in the NCR without going out of the network,” she stated.

For general questions about the program, contact the PHP front desk at 301-400-2110.

If you are having a mental health emergency, please call 911, 988 (988 Suicide and Crisis Lifeline), or go to your closest emergency room.

The Healing Power of Art - Healing Arts Exhibit

It's amazing to see all the artwork submitted for the Healing Arts Exhibit, hosted annually at Walter Reed by the Arts in Health program.

Healing Is An Art, Art is Healing:

Exhibit Highlights the Healing Power of Art

Photo By Bernard Little | Service members look at art included in the Healing Arts Exhibit on display throughout... read more

BETHESDA, MD, UNITED STATES 

11.01.2021 

Story by Bernard Little 

 Walter Reed National Military Medical Center 

Healing is an art, and art is healing was the sentiments shared among those who attended the opening ceremony for the 18th Annual Healing Arts Exhibit at Walter Reed National Military Medical Center Oct. 27. The exhibit showcases artworks by military members, veterans, retirees, family members, WRNMMC staff, volunteers and others, many who received their health care at the medical center. The exhibit will be on display in the pavilion between the America Building and the America Garage at WRNMMC throughout November, Warrior Care Month. 

U.S. Public Health Service Capt. Moira McGuire, chief of the Arts in Health Program at WRNMMC, has been one of the coordinators for the exhibit since it began. “It’s amazing to think we have been able to put on this exhibit for 18 years,” she said. While there’s been some changes, McGuire said what hasn’t changed is the enthusiasm and excitement on the faces of people and what they say as they go through the exhibit. McGuire, also assistant chief of Integrated Health Services at WRNMMC, added it has always been a team effort to put on the exhibit, supported and nurtured by the John P. Murtha Cancer Center at WRNMMC and the arts and health activities at the medical center. 

 The annual exhibit began as part of the medical center’s observance of Breast Cancer Awareness Month because most of the artwork was produced by breast cancer patients. The idea for the exhibit came when the hematology/oncology staff discovered the artwork patients were creating while being treated for breast cancer. Over the years, participation in the art show expanded to include the works by other patients, family members, staff and more. 

Brig. Gen. Jack Davis, WRNMMC director, added in addition to Breast Cancer Awareness Month, October is also National Arts and Humanities Month. “As the flagship of military medicine, we have a duty in leading the country in developing new and innovative resources to meet the challenging needs of our military community. These innovations include the emerging field of art and health.” He added the arts are “an [integral] and necessary component of the hospital environment to promote and maintain wellness.” 

Navy Capt. Carlos Williams, director of the National Intrepid Center of Excellence, agreed. NICoE, a part of WRNMMC, works to advance the clinical care, diagnosis, research and education of those in the military community with traumatic brain injuries and psychological health conditions, frequently called “the invisible wounds of war.” NICoE’s art therapy program, which has received national attention, started in 2010 and helps beneficiaries heal from the traumatic conditions, as well as express themselves and their emotions through art. “NICoE’s goal is to support people in holistically healing, and the creative arts program helps in accomplishing this mission,” Williams said. 

Louis Celli, an Army retiree, agreed. “We didn’t talk about our feelings during my generation of service. I didn’t understand what art therapy was, probably like the rest of the guys in my squad, platoon, company, and battalion. The evolution of the services to now recognize how important these types of programs are is instrumental in the healing process that goes on in the veterans we served with and interact with every single day, said Celli, who served as director of veterans affairs and rehabilitation with the American Legion. 

WRNMMC Command Master Chief Trey Hauptmann said art has always been a passion of his, “whether it was cooking and making the plates look appealing so my kids would eat, [or painting]. To actually spend time and create an emotion out of something, is what I’ve been always trying to do and what you will see in my art. It’s not one thing that I want you to see. I want you to interpret what you want to see. It’s your perspective that makes art great. It’s your perspective that makes the meaning come alive in your heart, your mind and your soul.” 

Veterans and former patients of WRNMMC affiliated with Uniting Us, a group focused on sharing the empowering quality of art, discussed their works and what inspires it during the exhibit’s opening ceremony. 

“Art has been a real gift to me,” said Dr. Alicia Christy, a retired Army colonel. “Art has allowed me to celebrate the heroes in my life,” she added. Christy’s portraits of “women who paid the ultimate sacrifice in the Iraq and Afghanistan Wars” are part of the Healing Arts Exhibit at WRNMMC. Her artwork has also been used in medical publications, and Colin Powell owned a portrait she did of him. 

Steve Alpert, a professional artist and veteran art mentor, taught art therapy classes at WRNMMC. He said his teaching philosophy is, “Artists make art to learn the truth about themselves. It’s about storytelling and your personal story, but no one has to know it’s your personal story.” 

April Goodwin-Gill, also an Army veteran, agreed. “The art I do has always kept me grounded. Sometimes, suicide is right around the door and I have to talk myself off the ledge. The way I do it is with my art. Thank God for the arts. Right when it seems like the ship is sinking, God will show me another way to be able to express myself, either through my paintings, dolls, stories and plays. I have to be able to express myself.” 

In his presidential proclamation for National Arts and Humanities Month, President Joe Biden stated, “We celebrate the power of the arts and humanities to provide solace, understanding and healing. We recognize the ability of the arts and humanities to amplify important and diverse voices and messages. We reflect on the fact that, as we have struggled with isolation, anxiety, and the loss of loved ones, we have turned to music and dance, literature and poetry, and philosophy and history to bring us together and help us persevere through, and grapple with, our current moment.” Biden added, “From our nation’s earliest days, we have recognized the arts as a foundation of our republic. As George Washington wrote in 1781, ‘The arts and sciences [are] essential to the prosperity of the state and to the ornament and happiness of human life.’ Today, any American, regardless of their background, can create art and turn to it for hope, acceptance and inspiration.” 

For more information about the Arts in Health Program at WRNMMC, contact Capt. Moira McGuire at 301-319-8755.