UniSA study: Trojan’s Trek is a world leader in supporting returned veterans deal with mental health issues

From The Advertiser, October 13th, 2013. By John Stokes. Original article here

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“A SUPPORT program that takes former soldiers trekking in the Flinders Ranges has been rated among the best in the world at helping young veterans deal with the horrors of war, a new study has found.

For the past five years the annual Trojan’s Trek has seen 10-12 ex-servicemen take part in the many diverse activities on the trek in the Flinders Ranges.  It is here where older veterans help younger comrades develop strategies to cope with their military-induced stress disorders.

The organisation Director is retired Lieutenant Colonel Moose Dunlop OAM.

UniSA Masters student Kendall Bird’s two-year study on the program, which was released at the Australasian Military Medicine Conference in Adelaide in Nov  has found that new bench marks in outdoor peer support programs have been set.  These rate the program as world’s best practice.

Lt-Col Dunlop described the Flinders Ranges as “the world’s biggest office in the largest consulting room in the world” said the setting allowed former soldiers to bond and take stock of their lives and relationships.

“Certain things happen in life which can cause anxiousness and depression which feed on each other.  Life becomes a big, big circle that goes from bad to worse,” Moose Dunlop said.  “That’s the way the returned men describe it.”

“The trek is a circuit breaker which results in individuals returning from the trek back into society as individuals who are highly motivated to change their circumstances .”

The program includes workshops and seminars as well as activities such as four-wheel-driving.

Moose said the study revealed most trekkers, in spite of being badly affected at the start, no longer showed signs of stress or depression, different to the community norms even two months after finishing the Trek.

He said the relocation of hundreds of soldiers from Darwin to Adelaide’s  Edinburgh Base in 2011, combined with the staged withdrawal from Afghanistan and the Middle East, meant more soldiers would soon be needing support.

“A lot of the soldiers will be back (at Edinburgh) and I reckon a lot of them will put their hand up and say ‘look, I’ve got a problem’.”   Moose aims to create a similar program for ex-servicewomen next year and is in the process of finding suitable female veterans to advise on content as well as take a lead.

Stephen Cates served with the army for eight months in Afghanistan in 2008  and found it difficult to adjust to civilian life on his return.

“I had a number of issues reintegrating, not so much into work, but into family life,” Mr Cates, 40, said.

“I self medicated with antidepressants and alcohol – which we all know doesn’t work.”

He said the trek gave him the chance to open up about his experience of war.

“We don’t want to tell people some of the things we’ve seen, done, heard – that’s not what we’re about,” he said.
“That’s where Trojan’s Trek comes in. It’s about peer support, being able to talk to someone.”

James Paterson, 31, served in Iraq for seven months in 2005 and went on Trojan’s Trek last month after “wasting a lot of years”. “If I hadn’t gone it was just a trail of self destruction,” he said.

“It’s all about the peer support. They’ve been there before and they’ve done it, and hopefully we can do it for the young guys that come through.”

The trek is now established as a not for profit Foundation with DGR status, ie all donations are tax deductible.

TROJAN’S TREK – GOVERNMENT HOUSE FUNCTION

 

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It was with gratitude that I accepted the invitation of the State Governor for him to host the supporters of the program to drinks at Government House on 6 December. As with all functions of this nature it was hard to draw the line at the agreed number of invitations to be issued. However, this was achieved with 50 supporters dressed in the appropriate finery attending. Both the Governor and his wife Liz were in attendance to welcome and chat with the group. The occasion provided recognition of their collective input in a relaxed atmosphere in a beautiful environment which could never have been achieved within my limited resources. It was also beneficial for the group to gain awareness of the breadth and scope of the program and each parties input.

Trojan’s Trek 2011- the most successful yet

The trek for 2011 is over except for the follow-up administration.  All in all I would rate it as the most successful yet.  Three weeks prior to commencement, I had names of only four participants and this was of great concern.  However the numbers increased during the last two weeks to total 11 by the time we deployed to the bush.  The reasons why veterans do not volunteer for something like this are many and varied.  In the first place, ex servicemen and women rarely volunteer for anything, it is part of the culture.  However, I suspect the two main reasons are the stigma associated with stress illness together with the difficulty in informing clients of the trek’s existence.

Overcoming the stigma of suffering from mental illness is something which the community face generally, and that will only dissipate with the passing of time.  Certainly the military is aware of this issue. Spreading the word was achieved in the end by enlisting the assistance of past trekkers, all of whom appear to know someone who is doing it tough.  There is no doubt that word of mouth and the reassurance of a mate goes a long way in prompting new trekkers to put up their hands.

My participant limit is 12.  Still 11 permits the group dynamics to operate in an atmosphere which is not inhibited by low numbers nor does it appear as if the facilitators are looking over every shoulder.  Besides, this group was a great mob.  They very quickly relaxed and spoke openly with each other and to the group as a whole. That makes the task of the facilitators easier and progress is fast and positive.

The age range was significant as I included two Vietnam veterans whose names had been put forward and I had the vacancies. I hasten to add that the target group remains contemporary veterans, ie post Vietnam, but I believe if there are vacancies, it is better to fill them with anyone whom we can help.  After all as Dogs says, “we do no harm.”

The youngest was 26 and the oldest 64 and although this may appear to be a disadvantage we have found that it is frequently helpful to have some older/wiser heads in the group.  This certainly applied in 2009 when the older veteran was a great help in breaking down the barriers and has subsequently maintained contact with one of that group as a father figure.  Also in this group were two second time trekkers who by their own admission gained as lot from a second attendance.  They had self nominated presumably realising a further trek was necessary to anchor some of the lesson from their previous experience.
This kind of response is heartening and confirms our belief that Trojan’s Trek is not a silver bullet but is a powerful motivator to effect positive change and as with most therapy, one experience is never enough.

The staff and I believe that the majority of the group returned with a very positive attitude towards changing their lives for the better.

This attitude potentially results in an improved life for partners and families; an aspect which we consider important.  Furthermore, I believe that there would be benefit in capitalising on the results of the trek by seamlessly adding these men and their families to one of the existing counselling services if not clients.

I was fortunate that the same team from 2010 was available.  This included Cogs (the camp commandant) and Shane (the chef), whose selfless efforts in planning, purchasing, cooking and delivering meals to us without a hitch.  It is a relief not have to worry about any of the aspects associated with that complex list of requirements.  All I do is allocate a budget figure and Cogs does the rest.  He and Shane travel to Moolooloo one day early to set up and prepare. They spent the week attending to our eating requirements which included cooking and then delivery to far flung locations and a final acquittal of the budget.  Cogs was allocated a general hand in the person of a past trekker, Townie.  He is familiar with the track system, the operation, the terrain and does not resile from washing up and other domestic chores.  I also contracted Paul Hodge Productions from Brisbane to make a DVD of the trip and its outcomes.  Paul is a veteran himself and told me during the trip that he was also receiving benefit from participation.  We all look forward to the DVDs.  Pioneer Tanks through Tim Harper was kind enough to loan two 4WD vehicles which saved in excess of $2000 in hiring, thanks Tim.

Our departure was red carpet like with the Advertiser on site to preserve the moment. Thanks to those who shared their thoughts and images with the reporters.

In the bush the team was comprised of the Director (me), Dogs, Poxy, AB and the Doc. Dogs was the primary facilitator assisted by Poxy and AB, both civilian experts who offered a different perspective and new subject matter.

The program for the bush period included 18 formal group sessions.  These were delivered at a number of different sites, varying from our over-night camp sites to predetermined locations en-route.


They were well received and are a marked departure from the omnipotent power point presentations.  I was impressed with the ingenuity shown by using the side of a vehicle with butcher’s paper and other simple aids.  The messages were clear and unequivocal.   Humour is always present and many of the boys later said they had not laughed as much for many years.  The Doc attended again, his second trip.  It is comforting to have a Dr on staff although we had two Senior First Aiders with us at all times.

The weather was not as kind as it could have been; one of the nights was wet and windy which is not ideal in swags. The days varied from a calm and sunny 22 degrees to very windy.  On the ridges it was impossible to carry on a normal conversation on those days.  But we have no control over that element and we continued on.  When it was not wet or too windy the nights round the fire were good fun. Lots of well told jokes and light hearted games made the night pass quickly and helped the boys relax.

On Tue we were joined by Ch 10s Brett Clappis and cameraman John from the George Negus show.  The program aired on Monday 3 Oct, was sensitively handled and conveyed the message of our intent.  A big thank goes you to those fellows who bared their soul on national television.
The final night was spent at the shearer’s quarters.  This enabled the participants to fill out their evaluations of the week and for the staff to carry out their own debrief.

The next morning was all go.  Breakfast at 0600 hrs, clean the quarters, showers, pack vehicles, load and get on the road.   We were mobile by 0750hrs although a flat tyre on one of the hire vehicles on the way out added 30 mins to the journey.  We arrived at the RAR Club at 1545 hrs, having cleaned all the vehicles en route.  Peter Caldicott from Channel 7 produced a news item for the evening bulletin.  The partners welcomed us back after which the Director presented monogrammed T shirts to the participants.  The trekkers then relaxed before some hurried off to catch flights home.

Moose Dunlop OAM
Director
10 October 11

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Walking the Kokoda Track for Trojan’s Trek

Hi, from both Gail and Aaron. We want to use our trek along the Kokoda Track in April to raise much needed funds for this worthwhile and very relevant cause, and we need your help!
The Challenge
The Kokoda track itself is 96km long, has many river crossings, and peaks at 2250 metres. We will complete the trail over a period of 8 short days, beginning on the 16th of April when we set out from Owers’ Corner. We reach the end of the trail, at Kokoda, on the 24th of April for a comfortable nights rest before attending an Anzac Day Dawn Service at the Bomana War Cemetery on the 25th. We are sure this will be a humbling experience.

The Significance of the Kokoda Track
For those who don’t know here’s a little background on the significance of the track:
– Until 1975 Papua New Guinea (PNG) was in fact an Australian territory, making it Australian soil during WWII.
– During WWII the Japanese wanted to invade Australia and to do so they first needed to get their troops, weapons and supplies to location much closer to Australia.
– Port Moresby (the capital of PNG) was the ideal location from which the Japanese could have successfully launched an invasion of Australia.
– In 1942 the Japanese invaded PNG in an attempt to reach Port Moresby.
– The Kokoda track is the 96 Km trail along which the Allied Troops successfully held off the Japanese from reaching their intended target of Port Moresby.
– Over the course of the battles it is estimated that over 3,600 Allied Soldiers and 13,600 Japanese Soldiers lost their lives and over 30,000 Allied Soldiers and 5,600 Japanese Soldiers were injured.
– For more detailed information on the trail and the numerous battles visit the Kokoda Commemoration.


The Cause
Since WWII, Australian Soldiers have been involved in many conflicts, including Vietnam and more recently those in Iraq as well as Afghanistan. Given the intense situations faced by those who enter active service it is not hard to imagine how difficult it could be to return home and be expected to just “switch off” and settle down into “everyday life”. The “Trojan’s Trek” is a program aimed at enabling returned servicemen who are struggling to settle down. It is a program designed and run by ex-servicemen who have personally experienced the same issues as those the program is designed for. This is a very worthwhile cause and we are taking this opportunity to raise money for the “Trojan’s Trek” as a means of giving back something to those who have given so much for us all. Help us to help these often unsung heroes by donating today.

How do I donate?
Simply click on the golden “Donate” button located on the top right of this page (and every page) or simply click here. This will enable you to donate via credit card or PayPal – a completely secure way to transfer funds over the internet. Thanks you very much for your generosity!

How is Trojan’s Trek different to conventional counselling or therapy?

Whilst there are a number of current programs available for veterans and families through Veteran and Veterans’ Families Counselling Service, none of them focus on or recognize the advantage of the involvement of “warriors” in delivery or veterans helping veterans. This simple concept has been employed successfully for many years with gamblers and alcoholics.

The differences between Trojan’s Trek and conventional counselling or therapy may be summed up as follows:
–    it is culture specific
–    it involves veteran to veteran delivery
–    it utilizes the remoteness of the bush
–    the program focus is on “victim to warrior”
–    a support group is formed, and
–    the process involves partners

The approach of Trojan’s trek has proved to be a powerful driver in promoting behaviour and life style change thus assisting in return to normal lifestyle for veterans and their families.

What is the cost?
The cost of conducting one Trojan’s Trek for 12 participants is about $35,ooo compared to about $107,ooo for an average episode in Ward 17.  By preventing just two veterans from attending the Repatriation Hospital as in-patients, the savings are approximately $17,800 making the cost benefits obvious.

The qualitative results which were documented by the Australian Centre for Post Traumatic Mental Illness following Trojan’s Trek 2009 are excellent. Indeed, as long ago as 1992, the benefits of veteran treating veteran were recognized. Previous Trojan’s Trek courses bear testimony to the veracity of this hypothesis.

Report for RAR National Conference Randwick NSW, 2010.

After two treks and having processed the information, seen the outcomes and spoken with the younger veterans, our belief in the value of this approach to military induced stress illness has been reinforced.  The value of veterans helping veterans from a different generation works extremely well.  As mentioned in the reports and in many societies this approach is adopted and is the basis on which information and advice is passed from one generation to the next.  The theory which explains this phenomenon in sociometric terms is cognitive behaviour therapy, generally referred to as CBT.  This is the theory of behaviour modification or change resulting from counselling, a word from which I tend to resile.  Nonetheless, it is the process which causes individuals to recognise problem behaviour and change habits for a better outcome, (insert family and community life).

In civilian and also DVA terms, this normally is affected by one on one counselling with a clinician or by prescription drugs.  What Trojan’s Trek has confirmed, certainly by strong qualitative evidence, is the value of shared experience in a remote locality with the tribal elder adopting the role of counsellor or in our case, an experienced veteran.  Our definition is that this is a culture specific approach to individual problems. This aspect of the experience is little understood by conventional therapists as they are seldom in a position to observe.  Nonetheless, it remains a very powerful tool to be used in the process of problem behaviour recognition and management.
One other aspect of the trek which cannot be applied to conventional treatment is the value of a remote live-in course free from all distractions.  This is the inherent value of going bush with a group who have shared similar experiences.  Many of you have heard of stories of veterans going bush, and irrespective of each individuals’ reason the common thread is to get away from society and its pressures.  To make one point clear, the trek does not advocate withdrawal from society as a solution.  That is not generally a viable outcome for a man, his family or partner.  The answer is to conform to those society and community standards and live as a productive part of it.  The result we seek is to achieve just that.  However, we do recognise the inherent advantage of having a captured class with similar backgrounds drinking tea round a dying fire with some smart conversation direction. The old adage, “a problem shared is a problem halved” is pretty much the truth from our experience. The trek is dry.

The other aspect of the trek, although difficult to measure but has a marked effect on the outcomes is the quality and credibility of the staff.  Currently we are using Dogs Kearney as the primary facilitator.  In this role he excels and has his own way of reinforcing the messages which are generally common at this level and type of behaviour session.  The point is, counselling is essentially what we do and although we are quick to distance ourselves from being labelled as therapists, in the true sense of the word some of the staff are just that.
On this last trek Moose included another staff member who has a clinical understanding of why some individuals respond differently to others in the same situations. This now is the domain of a discipline called neuro-linguistic processing, or NLP which adds another arrow to the quiver of trekker tools and exposures us all to the theory.

It has been stated previously we believe that the trek can be replicated given the resources and the will.  Certainly in SA we will continue to assist a number of troubled veterans at least once per year providing the funding and other resources are available.  That is the mission statement at our level.  However, we are also cognisant of the potential benefits which are offered by such a program to the military at large. The question is, do we continue to try to convince the military of the benefits of this approach to stress illness and if the answer is yes, how do we achieve that?

The reluctance or lack of interest which has been so far exhibited by the military is perhaps understandable. Although in the last two treks we have achieved very good qualitative results, the quantitative results as reported in the ACPMH report are not strictly in accord with this trend.  There are many explanations for that which I will not pursue here but as Norm Bell would say, “It is a bit like dissecting a frog.  All the parts add up to a frog on the ACPMH scale, but they are much bigger when looked at holistically”.

Although this apparent lack of support is frustrating, it is not any particular person’s fault.  It is always preferable to take side on the theory or ignorance as opposed to stupidity.  However at some stage, given that the veil of ignorance has been removed, our opinion may become more strident to the extent that one may not totally rule out stupidity or perversity.

I would like to spend a few moments explaining one of the issues which the TT staff become quite angry about.  As Moose would put it, “is it fair that the military take these young men and women to war and bring them back broken; then turn around and pass that problem to the free market to repair”? In effect this results in a number of young veterans, and I stress the young part, being thrust on an already strained mental health system to the detriment of both the soldier and the community.   This is the DVA adopted economic rationalists position of “purchasing services” with virtually no quality control or evaluation measurements at work.  The mix of ages in some programs run by both DVA and civilian resources does not engender good results. As a soldier who had completed a course in QLD said, “I have nothing in common with a bunch of old blokes in their 60s and 70s, I could not wait for the sessions to finish”.

This is why I would rather adhere to the ignorance theory as opposed to gross stupidity because if I didn’t I would become angry.

So where to from here?
It is clear to us in SA that this is a long term project which has two quite different objectives. One is strategic, the other tactical.
Strategy:  (National)
–    If the RAR Association is to continue to support this philosophy it needs to adopt a more aggressive attitude thus focussing on more specific outcomes.
–    Efforts to convince the military especially army, that this approach is a valuable adjunct to other forms of treatment will continue but this course must be mapped

Tactical
–    The SA chapter will continue to run the trek to support our veteran brothers and sisters in SA. This will involve some expansion of the base or skeletal organisation
–    Long term partnerships with local industry will be forged
–    Fund raising will continue based on commercial modelling at state level
–    The SA chapter will continue to provide advice to other potential project staff and locations
–    Independent data will continue to be collected to back our beliefs
–    Funds permitting, data will be interpreted and compared with DVA benchmarks, if available
–    Credible research to back our claims will be conducted, hopefully by a PhD student at Flinders University

Conclusion
It is clear that there is room for improvement in the way military stress is treated.  Not only is stigma a significant boulder in the path of early intervention, the military by its very nature does not encourage calls for help.  And that is understandable but is not in the long term interests of the employees.  One soldier was recently reported as saying that he put his humanity and ethics to one side and to operate at the limits of human ferocity.  They are strong words but the thrust and message is sound.  Do we make enough effort to humanise our soldiers on discharge or indeed after each deployment.  If we do not, what is the cost to the family?  As Lisa reports, “he was angry all the time and it was directed at me and the kids. It got to the point where if he yelled Samuel (who was four) he would drop to the ground”.

That is all such sad testimony to the way a fine force treats its members and understands the issues.  I don’t have the answers but I have lots of theories and I think better ways to utilise the skills humanity has learnt over many centuries. We must retain an open mind in order to heal the cracks in behaviour before they open irreversibly.  If we need to call on spiritual beliefs, religious beliefs, culture specific understandings or even mateship, we should be prepared to try them all.  There is no one size fits all answer.  For some TT may provide the answer, for others God in whatever form may be it.  But the message to the military is, don’t close your collective minds and continue to turn your back on your past servants.  The answers may lie in a combination of simple theories and practices which are available in your own backyard.

Michael von Berg MC
President
6 November 2010