NICoE Offers Holistic Approach to Psychological Care

WASHINGTON, DC—A holistic approach to care makes the National Intrepid Center of Excellence (NICoE) unique in how it treats servicemembers with psychological issues. “We not only have things like acupuncture, but we try to take care of the spiritual, the physical, and the emotional psychological health of the people that we serve, and the families as well,” said Navy Capt Thomas E Beeman, deputy commander for NICoE.

NICoE opened its doors to its first patients in October. The newly established center for TBI and psychological health is a 72,000 square foot, two-story facility located on the same campus as the National Naval Medical Center. With large open spaces, tall windows allowing for natural light to stream in, and even a playground located outside, the center is designed to cater to the needs of the patients and their families.

The center serves active duty servicemembers with TBI and psychological health conditions who are not responding to conventional therapy and are referred to the center by their provider. The patients come with their families for two weeks and stay in a nearby Fisher House. During their time at NICoE their injuries are evaluated, and when they leave they will have received an individualized treatment plan that they will continue with their provider.

While the new center is not operating at full capacity yet, leaders said that the center will eventually serve up to 20 patients at a time, a goal that officials are striving to meet by the end of March, according to Beemen. “Our great mission is to return as many warriors to active duty as possible, or at least to get them in the right place that they can enjoy really healthy and holistic lives.”

Addressing Psychological Health

The new center houses state-of-the-art equipment to assess and assist servicemembers undergoing treatment, such as the Computer Assisted Rehabilitation Environment (CAREN), which is a system that utilizes virtual reality for evaluating and rehabilitating a patient’s vision, reaction time, gait, and multitasking ability. Patients using the system stand on a large motion platform with an embedded treadmill that moves in sync with a virtual scene, such as scenes in which they must ski between flags.

Virtual reality suites are also utilized at the center. For example, a patient might utilize the clinical driving simulator for a driving assessment if they or their family report they are having some concerns with driving. Patients using the simulator sit behind a wheel while a driving scene is projected on the screen that the patient must navigate while their performance is assessed.

Services such as physical therapy, speech and language pathology, and recreational therapy are available at the center. Rooms for music therapy, sleep studies, and recreational therapy are also featured at the center.

NICoE Director James Kelly, MD, said the center is also designed to serve as a research hub for psychological health, as well as to provide training and education to providers, servicemembers, and families. “So as we learn from our servicemembers, from our efforts and engagements here locally, plus from our colleagues around the military and the academic and VA systems, we can then disseminate the information,” said Kelly. “That is a big piece of what we are doing.”

Air Force Maj Nathan Green


Air Force Maj Nathan Green was injured on April 20, 2008 during a rocket attack outside the US embassy in Baghdad while serving as a liaison officer between the US military and top Iraqi VIPs.  He was thrown to the ground head first and knocked unconscious.  Maj Green, who suffered no noticeable injury, was taken to the hospital to be observed overnight.  He was released the next day.

Afterwards, he suffered from headaches and other symptoms, but he continued his tour of duty.  When he returned home, Maj Green sought medical care for the symptoms that continued to plague him. In October 2010, after nearly 2-1/2 years of seeing various doctors for a mild TBI, he became the third patient to be evaluated at NICoE where he was finally given a treatment plan to follow.

Relieved to be on his way back to good health, Maj Green attributes the team approach employed by the clinicians at NICoE for helping to relieve his symptoms.  Over the years he said he had “15 doctors and none of them were talking to one another.  Here the patient will come in and receive one comprehensive treatment plan.”

Maj Green was planning to retire from the Air Force at the end of December.  He will continue his care at NNMC.

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