An integrative treatment approach for behavioral health symptoms in active-duty special operations forces with repetitive mild traumatic brain injury

Active-duty special operations forces (SOF) incur a significant burden of mild traumatic brain injury (mTBI) and posttraumatic stress-related sequelae. Integrative treatments may address multiple areas of functioning in this population. We examined the impact of an integrative treatment approach on behavioral health symptoms among active-duty SOF service members with repetitive mTBI history. 195 participants underwent a 3-week intensive integrative rehabilitation program at Veterans Affairs Palo Alto between 2021–2024. Rehabilitation psychology treatment consisted of six 1-hour individual sessions (2x weekly) incorporating psychodiagnostic assessment and eclectic psychotherapy. Five self-report measures of behavioral health symptoms were administered at admission and discharge. A subset (n = 55) completed select measures at 6-months follow-up. Linear mixed effects models examined treatment effects. After three weeks of treatment, there were statistically significant improvements in reported anxiety (adjusted, standardized ß=: −.85 [95% CI −.97, −.73]; p < .001), depression (ß: −.74 [95% CI −.86, −.63]; p < .001), posttraumatic stress (ß: −.48 [95% CI −.59, −.37]; p < .001), insomnia (ß: −.44 [95% CI −.56, −.32]; p < .001), and post-concussive neurobehavioral (ß: −.87 [95% CI −.98, −.76]; p < .001) symptoms. Improvements were largely sustained at 6-months follow-up. Findings suggest a novel brief integrative treatment approach may improve mTBI- and posttraumatic stress-related symptoms across multiple domains of well-being in active-duty SOF personnel, potentially in a lasting way. The current study provides insights into behavioral health and treatment response in an extremely specialized group of active-duty military personnel who are at increased risk of injury and related sequelae.