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For Brain-Injured Soldiers, Top Quality Care From a Philanthropist, not the Pentagon

At Project Share, started by philanthropist Bernie Marcus, brain-injured troops get cognitive therapy rehabilitation to relearn basic tasks of life —care the Pentagon’s Tricare health plan won’t pay for.

Bobby McKinney, 29, watches his favorite horse Bandit, right, run at the Chastain Horse Park in Atlanta. Members of the Project Share Program visit the park weekly to ride and groom horses, or just hang out. Bobby has been medically retired from the Marines with TBI, PTSD, PCSD and back problems after suffering multiple concussions while serving in Iraq. (John W. Poole/NPR/Redux)

Versions of this story were co-published with NPR and Stars and Stripes. For more coverage, listen to Morning Edition.

One afternoon this fall, Bobby McKinney hunched over a coffee table with a clear glass surface. A lamp with a bare light bulb illuminated it from below. Pencil in hand, the former Marine traced the pattern for a tattoo across delicate paper, a swirling, intricate design reminiscent of a Celtic cross.

McKinney's small apartment faded from his thoughts: The closet filled with shirts and pairs of jeans, hung three inches apart, all facing exactly the same direction, the way the Marines had taught him. The box packed with a dozen brown plastic medicine bottles. The worn couch that he slept on instead of the bed. The eraser board on his refrigerator where he had scrawled "A coward dies a 1,000 deaths. A warrior dies one."

Suddenly, a nurse's aide knocked on the door. Had he checked the oven? McKinney leapt up and ran to the kitchen, pulling out a tin of brownies on the point of burning.

"I guess I was just very focused on the tattoo design," he told a counselor later, pushing a camouflage baseball cap back on his head. "I set the alarm. I guess I just didn't hear it."

"Try to work on one thing at a time," she told him. "Multitasking is just asking the brain to do two or three things not too well."

McKinney, 29, nodded in agreement. It seemed so obvious once she said it. But his mind -- the mind that once helped sniper teams in Iraq, that navigated battlefield maps and complex rules of enemy engagement -- had just not come up with the idea to do one task instead of many. "When you think about it, it kinda makes sense. But I wouldn't think about it on my own," he said.

McKinney is an Iraq war veteran who suffered multiple concussions, also known as mild traumatic brain injuries. Bomb blasts jarred his brain, leaving him with no outside scars, but with nagging mental problems. His short-term memory is bad. He moves slowly through ordinary chores. He gets disoriented easily, and can't find his way to the home that he has lived in for months without the aid of a GPS.

A farm boy fond of the Georgia Bulldogs and chewing tobacco, McKinney has pinned his hopes for recovery on cognitive rehabilitation therapy, a subtle and complex treatment for a subtle and complex injury. Doctors and studies have shown that the therapy helps soldiers. But the Pentagon's primary health plan for soldiers and seriously wounded veterans, called Tricare, will not cover the treatment, saying it is still unproven.

To see what cognitive therapy looked like, ProPublica and NPR spent several days with McKinney and fellow soldiers and veterans at Project Share, a charity to help brain-damaged soldiers. The program is based out of the Shepherd Center for Brain and Spinal Cord Injury in Atlanta, a nationally recognized hospital for head injuries.

Former Home Depot magnate and philanthropist Bernie Marcus founded Project Share in January 2008 to fill the gaps left by Tricare and military and veterans hospitals, which often lack the expertise and staffing to provide a full-scale program of cognitive rehabilitation therapy.

Cognitive rehabilitation is "very time consuming. It's not an easy deal," said Marcus. "Isn't this worthwhile? Isn't this something we should all be concerned about? Whatever it takes is what we should give them."

Bobby McKinney pats a horse at the Chastain Horse Park in Atlanta. (John W. Poole/NPR/Redux)The visit revealed no flashy techniques, no cutting-edge medical devices. Instead, the men spent their entire days with therapists who focused on improving their memory, speech, balance and psychological health.

Soldiers got individualized treatment plans from a team of therapists who administered an intensive, two-week long evaluation to pin down their cognitive needs.

Therapists from different fields closely coordinated. A behavioral therapist provided counseling, since nearly all of the soldiers have post-traumatic stress disorder, a psychological injury which frequently accompanies traumatic brain injuries.

A speech therapist taught basic organizational techniques to overcome memory problems: How to make lists, how to pay bills, how to organize paperwork. A physical therapist helped them manage pain and relearn balance, which is often thrown off after a blast injury.

In the evenings, the men lived in apartments provided by the center. They did daily field trips, doing errands that are commonplace for most, but difficult for those with cognitive problems. They shopped at a grocery store. They cooked dinner. They helped assemble wheelchairs for the needy. They went to a horse park, where they combed, fed and rode horses.

At each step, a therapist helped them prepare for the job at hand. They suggested making to-do lists; using an iPod to keep track of medications; storing medical and military records into clearly labeled file folders.

Soldiers get a blue rubber bracelet with the initials SWAPS. The letters are supposed to remind them of a course of action should they become frustrated or mentally overloaded. The letters are an acronym: Stop; What's the problem?; Alternatives and options; Pick a plan; Satisfied?

The men stay for two and three months at a time. Afterwards, a Project Share worker follows them for up to a year to make sure that they are using the techniques they have learned to cope with life in the real world.

"It's very cozy and cocoon-like and warm and fuzzy here," said Tina Raziano, who visits soldiers and veterans at their homes and military bases to make sure they are adjusting. "When they leave here, they go through major, major changes. You really have to adjust to a new normal."

Cognitive therapy is not a silver bullet, nor is it a one-time treatment, or a rigid, well defined program. Instead, therapists here say, it employs a variety of techniques designed to do the hard work of retraining each soldier's brain to compensate for the things it can no longer do.

"We all see that they start out unable to do basic tasks," said Bonnie Schaude, a speech pathologist who coordinates many of the treatments. "People are leaving here, and they can function independently."

Brendan Jannesen, 23, was injured in a fall in Afghanistan in August 2010. A math whiz who helped to coordinate airplane and artillery strikes with soldiers on the ground attacking Taliban fighters, he struggled to do simple arithmetic when he awoke from his fall. (John W. Poole/NPR/Redux)The visit made just as clear, however, the difficulty of implementing such an intensive, long-term plan for the military or Department of Veterans Affairs. Official Pentagon figures show that 188,000 soldiers have suffered some kind of brain injury since 2000. The number includes blast wounds, but also head trauma sustained in vehicle crashes, training accidents and household falls. Previous NPR and ProPublica stories have shown that the number likely falls short of the full tally by tens of thousands of soldiers.

The vast majority of head injuries are concussions, from which most soldiers recover quickly. The only treatment needed is bed rest and perhaps pain medication for headaches. But providing the kind of care available at Project Share to even the small percentage of brain-damaged soldiers who need it would require a tremendous commitment of time and money from military and veteran medical systems.

Project Share provides more than 30 hours of rehabilitation a week for several months at a time, and a year of follow up. In contrast, most VA and military systems can provide only a few hours of therapy a week. All Project Share's services are in one building, across the street from the Shepherd Center and its scores of cognitive experts. Military and VA facilities can spend months recruiting a single neurologist at a base for 30,000 soldiers.

The Pentagon's medical budget is $50 billion a year, expected to skyrocket to $65 billion by 2015. The system already cannot fill the slots available for psychologists, counselors and neuropsychologists, who can make better money in the private sector. The VA also has to care for an enormous population of aging veterans, whose geriatric needs are far different than the needs of injured Iraq and Afghanistan war veterans.

Project Share even has the resources to fly in family members and spouses on private planes, the costs and time donated by volunteers. A pilot flew Tiffany Dantzler, 22, from South Carolina to Georgia one recent day to visit her boyfriend, Ashley Craft, so the two could receive joint counseling on what to expect from brain damage recovery.

Craft, 26, sustained burns and a brain injury in a 2006 roadside bomb explosion in Iraq. After the explosion, he could not remember his own name. A specialist in the Marine Corps, he was medically retired in August 2007. He suffered from post-traumatic stress. He got angry quickly. A mechanic who worked on military vehicles, he could no longer tune up a car back home.

Craft got treatment at VA hospitals in Richmond and Columbia, S.C., near his home. But each time he left the programs, he felt lost and abandoned, he said.

His captain in the Marine Corps heard about Project Share, and got him admitted. Craft now hopes that the intensive rehabilitation will help him return to a normal life. At a recent session on anger management, he tried to take notes on a handheld memory device, painfully typing in one pointer after another.

"You're not the way you used to be. And it's really tough to grasp that concept," he said. "I used to think I was pretty good, and now I have to use a lot of adaptive equipment to remind myself, or to even be half as good as I used to be. That's what I got to do. That's my life now."

Shy and hesitant when he talks, a man who has seen his expectations dashed more than once, Craft said he is more hopeful, now. Project Share provides him far more intensive care than he was able to receive in the military, he said. His girlfriend has already noticed a difference.

"He seems more confident about what he says. His memory seems a little bit better," Dantzler said. "He seems more alive."

Marcus, the philanthropist who supports the program, said the expense and effort are worth it. In July 2008, he visited officials at the Army Surgeon General's office to pitch cooperation between Project Share and the military. He got a tepid response, according to Marcus and several others present at the meeting. The military said it wanted to focus more on improving its own treatment centers.

Marcus left frustrated. He had visions of an alliance between the military and a nationwide network of civilian treatment programs. Instead, Project Share has treated about 70 soldiers since it began two and half years ago. Since there's no formal relationship with the military, soldiers generally get referred by word of mouth. The military sent one therapist to receive training.

"That's where the problem is, trying to keep it internal when in fact you don't have the resources," Marcus said. "If you can't do it yourself, outsource what you can't do. That's the name of the game." Military and VA officials "all say things that you want them to say, but the bottom line is, it's not happening."

As he talked, Marcus grew agitated.

"I don't feel that Washington has paid attention to this thing. I don't think that Washington has done enough on this. I blame the president, I blame the Congress, for not giving these kids the opportunity to go on with a fruitful life after they have devoted their service to this country and put their lives on the line," Marcus said.

"It just doesn't make sense to me. It frustrates me. And it angers me. Kids are wandering around the streets today that will become tomorrow's criminals that were yesterday's heroes. How pathetic is that?

"We owe these kids a hell of a lot more."

Brendan Jannesen is working on issues with his knee, playing Wii ping-pong while balancing on a balance board. Brian Smith, left, is a physical therapist working with veterans in the Share Program. (John W. Poole/NPR/Redux)Cpl. Brendan Jannesen, 23, a special forces soldier in the 75th Ranger Regiment, was patrolling at night in Afghanistan in August 2010 carrying heavy gear when he slipped off a trail, falling down a steep slope.

Tall, thin and fit, Jannesen had been a forward observer, trained to coordinate airplane and artillery strikes with soldiers on the ground attacking Taliban fighters. A math whiz, he could simultaneously juggle people screaming in both ears as he figured out the angle for incoming mortar strikes in the middle of battle.

When he awoke from his fall, however, Jannesen struggled to do simple arithmetic. He had to use his fingers to add. Jannesen's sergeant sent him to Project Share, hoping that its intensive approach would help.

Sitting in a common room with a poker table, Jannesen became passionate as he described how much he wants to return to duty, how much he has improved so far.

"I could do degrees, azimuth, you have to calculate the time of flight, the number of rounds, how fast your target is moving to try to get a direct hit on target. It was very, very heavy on cognitive demands," he said. "Now, I get worn out trying to write out a to-do list. It's very, very frustrating and very difficult to handle. You want to do stuff, but you can't do it."

About half the patients at Project Share are veterans, medically retired from the service and hoping to return to civilian life. The others are active duty soldiers who aim to return to their units. They are mostly Marines and special operations soldiers whose superiors have heard about the program through the close-knit communities that characterize those two forces.

Therapists say that nearly all of their patients are motivated: To get better, to navigate their lives, to recover from a baffling condition that has fundamentally changed the way they think and act in ways all but invisible to the outside world.

Mild traumatic brain injury "can be a blessing and a curse," said Irene Spychalla, case manager for Project Share. "These guys look completely healthy. They're walking, they're talking. You don't realize they're struggling with their daily lives."

A Marine since 1998, Sgt. Orville Wempner, Jr. was sitting on a tarmac in Iraq in 2004 when a mortar landed nearby. He remained conscious but was left with pounding headaches for weeks afterwards.

A water purification specialist, Wempner grew perplexed after he started having trouble operating the enormous, 5-ton pumping machine whose internal workings he had mastered long before the blast. He began to carry around a small green notebook to write down all his tasks. One day, he was alone taking care of his 6-year-old daughter and he simply forgot to feed her dinner.

Wempner, a Minnesotan known to his friends as Junior, knew that something was wrong. His brain, he said, was like a car engine with miswired spark plugs.

Wempner said his brain "feels like it's misfiring. There are days that I'm sitting there and everything is clear and then there's more days when I'm confused, not knowing what I'm supposed to be doing, where I need to go."

Wempner entered the Project Share program in September. Therapists worked hard on helping him learn to organize and prioritize. They retaught him to make lists. They trained him how to keep a calendar with all his appointments written down.

Basic stuff. But for Wempner, they were the tools to getting his brain working right again.

"It does sound pretty simple and down to earth," he said. "But when you're not thinking clear ... simple things like that don't really work."

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Victor R. Volkman

Dec. 21, 2010, 5:37 a.m.

I believe the cognitive therapies could be substantially augmented by incorporating Traumatic Incident Reduction (TIR) into it.  TIR is a one-on-one, exposure therapy, which has been shown to be effective with military PTSD symptoms.  See http://www.TIR.org or I will be happy to send you a copy of my book on the subject “Beyond Trauma: Conversations on Traumatic Incident Reduction”

We can not afford to fail our men and women who put everything on the line to protect our freedom. The sacrifice they made for us must be matched by our own sacrifice to assure that they are returned to our communities in the same condition in which they willingly left to serve our country.

Here is the link to the Shepherd Center if you need assistance or know of a service member who does:

http://www.shepherd.org/patient-care/care-for-us-service-members

To my fellow head injury brothers and sisters, it may take years, but the fuzziness will recede. Keep trying to think, keep forcing yourself, it gets better.
C

Where can I learn more about Project Share and helping out? I can’t find a website.

@Nicole—click my link in the comments above which is for the Project Shepard.

“The others are active duty soldiers who aim to return to their units. They are mostly Marines and special operations…”

A Marine is not a Soldier.  He is a Marine.  Soldiers are in the Army.  Let’s not forget that Sailors and Airmen, in the Navy and Air Force respectively, are also injured. You could use the term “service members” to refer to all of the above.  Please don’t call everyone a soldier.

Terry Bearden

Dec. 21, 2010, 4:03 p.m.

It astounds me that SSRIs (which carry FDA-mandated Black Box Warnings about suidical/homicidal ideation, increased aggression, uncontrollable restlessness/agitation, hallucinations, insomnia, anorexia, psychosis, mania, hypomania and many other dangerous side effects) are being used by the barrel on our injured troops despite meta-analysis that showed this class of drugs to be less effective than placebos while therapy recommended unanimously by a panel of experts is ignored. The pharmaceutical industry does not profit from cognitive therapy. Follow that thread and you’ll discover the real reasons behind this travesty. This is totaly un-American. Didn’t we, as a nation, learn anything from ignoring the problems our Viet Nam vets had when they returned home? Take a look at our streets. Ask any chronically homeless man in his 60s…I’ll bet dollars-to-donuts he’ll admit to being a Viet Nam vet. In 35 years, will people say the same about our actions, or lack thereof, now?

I agree..we owe our service men and women a LOT…I am glad this program is a step in the right direction….I was wondering if this type of program could help with cognitive abilities in people who suffer with Multiple Sclerosis? I would be VERY INTERESTED in someone’s opinion on this!

Terry Bearden

Dec. 21, 2010, 4:26 p.m.

@ Karen: I do not know whether cognitive behavior would help with MS symptoms. I have heard that many people with MS see great improvement if they go horseback riding regularly. Something about the rhythmic movement. Check it out. This program WOULD be a step in the right direction but the VA and Tri-Care refuse to refer “service members” to it or pay for it so very few access it. That’s the travesty.

Is there a program of any kind for service members in the Phoenix/Mesa, AZ area.  I’d like to volunteer to help.

In a previous article about injured soldiers and denied cognitive therapy services, Robert Gates expressed his deep concern about the ballooning costs of medical care for the military.

Although in recent years there have been some improvements in psychiatric services available to active & discharged soldiers, the continuing need is greater than services available.  There’s also been exposure of devious methods used by Pentagon health services to deny help for battle induced brain traumas and mental health issues by claiming pre-existing mental & cognitive conditions.

Back safe at home, the Pentagon has not been subjected to a full audit on their general budget or expenditures for years.  There are numerous instances of lack of fair bidding processes for large, expensive projects that often come in way over original projected costs, of horrendously inflated cost estimates for materials ordered from one year to another based on last year’s (horrendously inflated) estimated costs, etc..

The money flies out of the Pentagon budget faster than they can begin to account for it, with no one challenging those expenditures.  Remember the $700.00 hammer?  The legends of ridiculous extravagances within the Pentagon budget are epic, and often proven, but so it goes….

Pentagon military leaders ensure that America remains embroiled in 1 or more “conflicts”, often of our instigation.  They ship off thousands of American citizens to “defend our honor and safety, spread democracy,” then express the county’s appreciation of those soldier’s bravery, hardships, and injuries by reducing badly needed medical services as too expensive, or not proven effective (according to their studies).

It’s insulting to the armed forces and vets for their leaders to make budget cuts that limit availability of vital medical and psychological services to deal with the human damage & devastation their wars have caused-

especially when they are so flagrantly careless with the billions of dollars they make no attempt to account for.

The lack of respect is appalling, but it is, after all, the currently vogue American way!

justin purchin

Dec. 21, 2010, 9:22 p.m.

If we as American citizens cannot afford to pay for the healing of our wounded armed service men and women with all our wealth, we cannot afford to continue sending our youth to war.
Our true wealth are the healthy, trained and educated
children not cannon fodder and unhealthy war veterans.
It is time to make a decision where we want to be
as a nation of the future.  A lead nation for peace and
not an empire of greed, war, destruction and the merchants of death.

Great article. I’m disgusted that our nation has its priorities screwed up!  We need to make the men and women who serve our country our number one priority instead of trying to coddle and give citizenship to the illegal invaders who leach off the system and demand citizenship.  It sickens me to think of what illegals cost American taxpayers when that money could be going to our injured military people who deserve it!  What a travesty of justice and a huge embarassment!  Please post this article on your Facebook, Twitter, etc. pages so we can spread the word about this wonderful program.

It makes me proud to be an american when I see robber barons of the 20th centruty giving back to the community/country. When the US government under the republican domination of of the late 19th century failed the populus, the individualr who benfited from that failure stepped up and spent their wealth acquired under those regimes to better the country as a whole. Bernie Marcus a poor boy from Brooklyn, who married the right girl, was a sharpe cookie and was in the right place at the right time and was able to amass millions and then took it upon himself in his later years to benefit people who the government denied help and care. Thank you Bernie, you are beyond a great human being. All of those years and million that you made with the help of a goverment that was just plain “paid off” My question remains, where are the boys from Goldman-Sachs, BofA etc. etc? I guess they and their associates are still counting coin.

Were it not for the money of America’s wealthy financing the propaganda storms that precede America’s elections - the great masses of targeted ads designed to arouse negative emotions which have empowered each and every Republican victory these last two decades - battle injuries in Iraq and Afghanistan would not be such a problem, for Iraq would never have happened, and we would have gone into Afghanistan, gotten OBL, and left - as per the original mission parameters.

So I look at Mr. Marcus’ work as an example of a small miracle for with his actions, he flies in the face of the ways of so many of America’s wealthy who, too often, prefer to look at the American people as being merely “labor”:  Tools, to be used until they break and then discarded, be they clerks, assembly workers, 9/11 rescue workers, or soldiers.

Congratulations, Mr. Marcus.  While I am aware of others who reside in our top 1% who do not share the callousness that greed so often brings - that uncaring, unthinking, myopic face of the vast majority of America’s political right - I find myself occasionally in need of a reminder that it is as easy for some of us to stereotype America’s wealthy as our right finds stereotyping the unemployed and destitute.

Thank you for breaking the mold.

I will begin cynically by stating that we would have to be far less concerned with these tragic circumstances if we had not started the two illegal invasions of sovereign countries; we would have been further ahead as a progressive democracy (what’s that?) if we had tried the perpetrators of these wars in our own Federal Courts under Geneva Convention and Nuremberg Guidelines and jailed them
That being said, it is simple to just state like others here that there is no profit in trying to rehabilitate our veterans from such terrible injuries.
My father, his two brothers were severely injured from shell shock and chemical warfare in the First World War in Italy…...
Until we realize that we cannot have “good wars” that will result in “low collateral damage” even to our own young we will not have moved one iota into transforming ourselves from an evil country into a civil one.
How much is involved in the Pentagon “Black Budget”?  Billions on billions of dollars.
We are a country of greed and hypocrisy…led by political leaders who are evilly corrupt on both sides.
Follow the money!

As Americans, until we can vote on going to war with another country, we are not free.  We do not live in a democracy.  Our country is an imperialistic oligarchy.
One that is ruled by the wealthy elite and invades other countries on a continual basis.  If you have the opportunity, listen to comments about the US made
by people in other countries (check out foreign newspaper websites and read the comments).
You’ll get the truth there.

“With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation’s wounds; TO CARE FOR HIM WHO SHALL HAVE BORNE THE BATTLE, AND FOR HIS WIDOW AND HIS ORPHAN—to do all which may achieve and cherish a just and lasting peace, among ourselves, and with all nations.” Abraham Lincoln, March 4, 1865 (emphasis supplied).

To “Truebee”—what is it about the rich, those who took chances and built up a company from scratch, that you have an ax to grind?  He’s doing a good thing for those who make the ultimate sacrifice for this country, so people like even yourself can run your mouth about the “evil rich people” in the US.  You have the same opportunities as anyone else to create your own wealth.  I’m not wealthy, but one day plan to be, through my own hard work.  Stop blaming the rich for everything.  Have you met any poor people who create jobs are add to the economy?  NO, they TAKE from the American taxpayers.  More people are on “SNAP” (food stamps!) than any other time in history.  You can credit The Messiah Obama on that one.  Get people dependent on gov’t so then they’ll vote for you.  You liberals are all the same—no common sense whatsoever!

One of these days somebody is going to trot that trite line about “Poor people don’t create jobs - the rich do!” out and once…just once….they’ll stop to think:

“Huh…if the rich are creating all of these jobs, why do we have ever more poor people?”.

On second thought, that won’t happen; that would require that those who make that argument look within themselves to try to understand how they can so deeply believe “Greed is good!” that they are blind to the reality of America today - and that seems to be increasingly difficult for those who choose to blame poverty on the poor to do.

Hey…if the rich create jobs, do the poor destroy jobs?

That would be a handy argument for the Republicans, wouldn’t it?  And it is certainly no more obscene than “flood-up/trickle-down” economics.

The thing that helped me the most after my brain injury was cranial sacral treatment delivered by an osteopath (ie. someone really trained).  That treatment allowed all of the therapies I received to work more effectively, including cognitive therapy.  Without the osteopathic care, 20 years later, I likely would have still been in therapies.

Rosalie Ackerman

Jan. 12, 2011, 1:26 p.m.

Why is the military denying CBT to veterans?

IN MY CLINICAL PRACTICE I DEVELOPED:

Multimodal Neuropsychologically Informed Biofeedback Treatment

for Women and Men Clients: Head and Body Injuries from Intimate Partner (IPV), Family Violence (FV), and Child Abuse (CA).

Published cases included:

Applied psychophysiology, clinical biofeedback, and rehabilitation neuropsychology: a case study—mild traumatic brain injury and post-traumatic stress disorder.
Ackerman RJ.
Phys Med Rehabil Clin N Am. 2004 Nov;15(4):919-31, viii.
PMID: 15458759 [PubMed - indexed for MEDLINE]
Related citations

The Cochrane Collaboration provides up-to-date reviews of all relevant RCTs of health care. Cochrane’s suggestion that the methods used to prepare and maintain reviews of controlled trials in pregnancy and childbirth should be applied more widely was taken up by the Research and Development Programme, initiated to support the United Kingdom’s National Health Service. Funds were provided to establish a ‘Cochrane Centre’, to collaborate with others, in the UK and elsewhere, to facilitate systematic reviews of randomized controlled trials across all areas of health care.
I was identified as brain-behavior evidenced based research for txt of mTBI/PTSD

Ackerman, RJ, & Banks, ME: Assessment, Treatment, and Rehabilitation for Interpersonal Violence Victims: Women Sustaining Head Injuries. In M. E Banks, & E. Kaschak, (Eds.), Visible and invisible disabilities in the lives of women. Women & Therapy, 26(3/4) 343-363, 2003.  3 clients

African American women of incest from family, rape, and consequential children IPV, FV. and CA
Banks ME, Ackerman, RJ: Physical (especially head) injuries experienced by African American women victims of intimate partner violence. Women & Therapy 25 (3/4): 133-143, (2002).  

African American 18 year old mother, twice raped with two resulting babies: IPV, FV. and CA
Banks, ME: The role of neuropsychological testing and evaluation: When to refer. State of the Art Reviews: Adolescent Medicine, 13, 643-662, 2002.

This procedure is close to neurobiofeedback treatment option.

Rosalie J.Ackerman Ackerman@abackans.com

This article is part of an ongoing investigation:
Brain Wars

Brain Wars: How the Military Is Failing Its Wounded

The military has failed to diagnose brain injuries in thousands of soldiers returning from overseas.

The Story So Far

Traumatic brain injury is considered the “signature wound” of soldiers fighting in Iraq and Afghanistan. Official military statistics show that more than 115,000 soldiers have suffered mild traumatic brain injuries since the wars began. Shock waves from roadside bombs can ripple through soldiers’ brains, causing damage that sometimes leaves no visible scars but may cause lasting mental and physical harm.

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