Deborah C. Beidel, PhD, ABPP, Trustee Chair and Pegasus Professor of Psychology and Director of UCF RESTORES talks about the program and how it is helping participants.
Interview conducted by Ivanhoe Broadcast News in July 2019.
Can you tell me when Restores was founded? What it started as and why you saw a need for this?
BEIDEL: Restores was in existence as a research project since 2011. In 2017 we moved from a simple research project to a clinical research center here at UCF. We saw a need for this because as people learned that we were treating people who had trauma, more and more people were requesting services. We started treating veterans and now we treat first responders. We treat survivors of mass shootings. We treat sexual assault victims. So we’ve grown in size.
Can you give me some stats on PTSD? How many soldiers that go to war come back with it?
BEIDEL: The best estimates that we have is that at any one time about 8 to 12% of veterans will have post-traumatic stress disorder. Others will have what we call sub-syndromal PTSD so they’ll have some of the symptoms but not all of them. But even having subsyndromal PTSD can impact daily functioning.
What about the suicide rate?
BEIDEL: For veterans, the suicide rate is calculated at between 20 and 22 people a day. We know it’s much higher than it is for the general population.
Can you tell me about the programs? How long they are? Who can participate and what they offer?
BEIDEL: At this point, our program is open to anyone who is experiencing post-traumatic stress disorder as a result of a traumatic event. We have two programs. We have a traditional outpatient therapy program which you might think of as going to your therapist once a week. What’s really innovative about us is that we have a three-week intensive outpatient program where we provide 29 sessions of treatment in a three-week period of time. So people come here and they’re in therapy for two to three sessions per day, five days a week, for three weeks.
I know you guys are big on the exposure therapy. Can you tell me about your research on that and what kind of results you’ve seen?
BEIDEL: Exposure therapy is probably the treatment that has the most scientific evidence behind it for post-traumatic stress disorder. And if you think about it, if I asked you to get over your fear of a dog you’d say, well, I have to be around dogs. Yes, but you have to be around the kind of dog that created your fear. So, if you’re afraid of German Shepherds and I bring in a little French poodle it’s not going to be an effective exposure therapy. With people who have experienced traumatic events like IED explosions, that’s not something I can recreate in real life. So that leaves us with either asking you to imagine what happened or using virtual reality to help you imagine and become immersed in the traumatic event. It’s important to say that the idea is not to make you feel comfortable that you saw your best friend get hit by an IED. It is the fact that when traumatic events occur, everything in that environment becomes associated with that event. So now just the smell of diesel fuel, even if you’re here in the United States, can trigger an episode of PTSD. Seeing trash by the side of the road on an interstate in the United States, you might immediately flashback to that trash on the side of the road in Afghanistan, which was an IED explosion. So, we need to get people back to understanding and retraining their brain that trash is not a signal that a bomb is going to explode, that it’s just trash on the side of the road.
Earlier we were just talking about how you can’t necessarily trust that someone is imagining when they’re saying they’re imagining. Can you talk about that a little bit?
BEIDEL: If you think about it, these are very horrific traumatic events, right? This is not something that is, “oh I’m traumatized because I dented my car.” We’re working with people who have unfortunately seen the very worst things that happen in life. It’s not something someone would want to try to imagine. It’s not something that people imagine easily. So virtual reality allows us to not just trust your imagination and that you’re imagining it properly, it makes sure that we are giving you all of the cues. And if you think about it, imagination is mostly visual. Right? We have a harder time imagining sounds or imagining smells. So, by presenting you with those sounds and smells as well as the visual, we can completely immerse you in that event, expose you to the triggers, and help you overcome your fear.
And does adding the scent make therapy more effective?
BEIDEL: We believe it really does. What we know about scent is that from your olfactory bulb which is at the end of your nose to your brain, the run as we call it, the nerve, is very straight. And it goes right into the amygdala and hippocampus. These are the worry centers of your brain and also the memory center of your brain. So smells that are associated with trauma are very intense. And they’re very emotional smells. So, they’re difficult memories to get rid of. They make the memories become very emotional and very intense. And so that’s why exposing them allows us to do an even better job.
How does that work with the scents? Is it a machine or are they just holding it underneath the nose?
BEIDEL: There is a machine. There’s a machine that we have and we can load different scents into the machine. And then as we’re going through someone’s trauma narrative as we call it, if we get to the point where they say, “and then I smell diesel fuel,” the therapist is able to click on the button that says release diesel fuel. And there’s a fan that blows the diesel fuel right out into the area where the patient is sitting.
That’s interesting. Can you tell me about the results that you’ve seen so far for this program?
BEIDEL: In our controlled trials that we have done, and we’ve done two at this point, with veterans and active duty personnel, we have found that at the end of the three-week treatment program, 67% of participants with combat-related PTSD no longer meet the diagnostic criteria for the disorder, though they may still experience some symptoms. And six months later the relapse rate is only one percent. Sometimes people say to me, well, what about the other 33%?
How many people have you treated?
BEIDEL: If we count all the people that we’ve treated from the start of our research trials in 2011, at this point we have probably treated over 500 veterans and active duty personnel. We have treated about 225 first responders and we have treated sexual assault survivors and we’ve treated survivors of mass shootings. So those numbers are probably, particularly in the case of mass shootings, more in the area of 10 to 20.
I know you just listed the people that you treat. Are there any more people kind of outside of the veterans, first responders, sexual assault and mass shootings?
BEIDEL: We’re also right now treating survivors of Hurricane Maria who have moved from Puerto Rico to the central Florida area. Many of them are still having problems after the hurricane when it gets cloudy here, when we get thunder here, that triggers the memory of being in that hurricane. So, we’re treating both adults and children who have come here from Puerto Rico.
I never thought of that before for those people, it’s extremely traumatic.
BEIDEL: It’s very traumatic. And here in Florida we have an issue with the hurricane that hit the panhandle. The suicide rate over in the panhandle has increased dramatically because of the lack of enough mental health services available in that area because everything’s been decimated. And the fact that people just can’t get their lives back because of the extent of the damage. It’s really quite serious.
Why is it important for people to seek help when they’re suffering?
BEIDEL: Because help is available. There are good effective treatments out there for post-traumatic stress disorder. And people need to know that they exist. Something that happens is sometimes the first therapist someone meets is not the right therapist for many reasons. They don’t click interpersonally, the therapist may not be qualified to do the treatment, and it’s important for someone to go and find someone else. Find someone else who can provide the right care. This is a disorder that is treatable. You will never ever get over it completely to the extent that you don’t remember that traumatic event anymore. That would be silly. That event is always going to be there. But it doesn’t have to rule your life. And that’s what’s really important is that someone is not defined by their post-traumatic stress disorder. It’s a part of their life but it doesn’t rule their life.
Is RESTORES only for people in central Florida or can anyone come to you guys?
BEIDEL: Anyone can come to us. We have treated military personnel from at least 25 different states. We have treated people from all parts of Florida. We cannot offer housing or transportation at no cost if someone does not live in Florida because our state has funded us to treat citizens of Florida at no cost. But we do have the capacity to treat people from other regions. And they could call and we could talk about what arrangements we could make.
And you have two locations?
BEIDEL: We do. We have the location that’s here on the UCF campus and we have a second location over in Brevard County which is over along the coast in Daytona. That area has the fourth largest number of veterans in Florida. And we were asked to stand up a clinic there because of the need for treatment.
How might this program be impactful on a national level?
BEIDEL: What we’re hoping to do is to have other people learn the program that we’re doing and want to put it in other places throughout the country. So later on this fall we are going to be rolling out what we call a nine-credit graduate certificate in trauma and trauma management therapy. That will be available online through the University of Central Florida. People will be able to register, take those courses, get that certificate, and be trained to set up a clinic or in their private practice be able to do the same type of treatment.
So can people enroll in the fall?
BEIDEL: I’m not quite sure when we’ll be ready to enroll because it’s almost time for fall. I would say that we’ll have it ready at definitely to enroll in 2020. They’ll just have to either contact us on the website or look online.
Are there any other treatment centers looking to mirror what you guys do?
BEIDEL: My colleagues at Texas Medical Center are hoping to stand up the same treatment program over in Houston. And we’re always willing to talk to people. Virginia Tech is right now doing a program out of V.A. there, the same three-week intensive treatment program to see how it works within a V.A. setting. So there are people who are starting to pick it up. And it’s becoming clearer and clearer that the intensive outpatient programs are really the way to go in order to treat people because the treatment effects come faster. And that gives people hope. So when people see that they’re beginning to get better in a short period of time that allows them to stick it out and finish the rest of the program.
So there’s no cost to Florida residents. Do you have any idea of what the ballpark price would be for somebody from Ohio who wants to get help?
BEIDEL: Yes. We’ve calculated that including the housing stay and the transportation (depending on how people travel) it would be between eight and $10,000. But as I said, that number accounts for transportation, lodging, and meals. The therapy by itself is probably closer to five to $6,000.
Where does the majority of the funding come from?
BEIDEL: Our funding comes from three sources. Some of it the early funding came from the federal government in the form of research grants. Our current funding, most of it, comes from the state of Florida. We have some funding for Pulse survivors and families and also for Hurricane Maria survivors from federal agencies that deal with these kind of very traumatic events.
Perfect. Do you guys take donations as well?
BEIDEL: We do, yes. We do have a foundation account that is set up. We’ve had a very generous donation from one couple, Mr. and Mrs. James Rosengren who have made an initial donation of $1 million to get the clinic up and running. So that’s been very helpful for us.
END OF INTERVIEW
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