A new VA program is helping to fulfill one doctor’s purpose of delivering compassionate and effective care to Veterans at Central Virginia VA Health Care System. Dr. Jarrod Reisweber and colleagues created Transcending Self Therapy to improve substance abuse treatment for Veterans.
Reisweber is a clinical psychologist and author of Transcending Self Therapy (TST). TST is an addition to Cognitive Behavioral Therapy (CBT). While CBT is a psychotherapy focused on improving a person’s thought and behavior patterns to boost emotions, TST identifies what a person’s higher moral standard is and helps them reach that standard.
The inspiration for TST grew from Reisweber’s memory of his grandfather, who served as a bomber pilot in World War II. His grandfather survived the war, but lived with an internal battle that affected his relationship with his family. Despite suffering from Alcohol Use Disorder, his grandfather was a proud patriot who doted on his wife and provided for his family.
“I believe my grandfather’s drinking was influenced by his time in combat and may have gotten worse when his son, my uncle, died by suicide,” Reisweber said.
Reisweber remembers his uncle as a great athlete, a popular and very likable man. Yet he also struggled with substance abuse. His suicide came as a shock to the family. For Reisweber, though, it influenced his career choice. He was drawn to psychology after years of noticing how he showed compassion for others–those who struggled with suicide, mental health issues and substance abuse. He proudly serves Veterans now.
Though he never donned the uniform himself, Reisweber was encouraged to take a different path. Now, at VA, he dedicated his mission to improving Veterans’ quality of life by helping them reach their highest potential. He understands the toll and struggles Veterans face no matter how many programs and services are offered.
“I truly believe the VA system is better than any hospital system in the world,” Reisweber said.
More than just CBT
TST helps patients get in touch with their morals and change unhealthy thinking and behavior patterns. Clinicians identify what qualities Veterans feel they are lacking by evidence of their thoughts and behaviors. After a quality is identified, it is used as a moral compass for treatment. Veterans improve on problem-solving, coping, goal setting and psychosocial skills through individual and group therapy. This helps them achieve the best version of themselves.
“Substance Use Disorder (SUD) rates among Veterans are higher than in the general population. If clinicians across the VA and the country were to start using this treatment now, we’d have a good chance to influence the SUD crisis immediately.” – Dr. Reisweber
The program that helped spread Reisweber’s idea is the Veteran Health Administration’s Innovation Network. This network offers connections by which innovations can be funneled and vetted to bring improvements to patient care. The VHA Innovation network helps test ideas to improve access, increase quality, drive down costs and drive up Veteran satisfaction. On-site personnel called innovation specialists guide clinicians and others to design, develop and implement their products.
“In Research and Development, traditional research takes an average of 17 years to go from a concept to a patient’s bedside,” said Suzanne Shirley, innovation specialist at the Central Virginia VA HCS. “When innovative solutions like TST are developed using human centered design and VA funding, the impacts are felt in real time.”
The data collected during the implementation phase far surpasses the results of typical treatment. Sixty-eight patients participated in the 20-day residential treatment program. Results show one month after treatment, those who used TST were less likely to relapse than those who did not receive TST. Reisweber will present his TST program findings at VHA’s Innovation Experience (iEx) in Washington D.C.
Through the Innovation Network, projects go through three phases: spark, seed and spread. Spark refines the idea. The seed phase seeks to improve the designs based on feedback and marketing strategies. The spread phase scales the innovation to multiple sites across the country. Selectees receive $10,000, $50,000 and up to $200,000 respectively.
In real time
“It’s a great example of how something sparks as a small concept by a front-line provider and builds into a refined product spreading to 50 different medical centers across the country,” Shirley said, adding that VA serves approximately nine million Veterans.
Shawn Davenport, an Army Veteran participated in TST.
“I had situations where I would usually handle it incorrectly. But being that I’m thinking on my thought patterns and I’m seeing what’s motivating my actions, I can stop them before they become negative.”
Reisweber says patients in the intensive outpatient and residential substance abuse programs at the Richmond VA are seeing significantly greater reductions in substance abuse and depression compared to what was done before and the treatment is garnering national attention.
“I am so grateful for the opportunity to develop this approach with colleagues and provide this care; care that I wish had been given to people like my uncle and grandfather,” Reisweber said.
Megan Kon is a public affairs specialist at the Richmond VA Medical Center.