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TREAT SAW: an integrated model of MDMA-assisted therapy and Save A Warrior’s evidence-based practices for holistic healing of complex post-traumatic stress (C-PTS) in California’s returning veterans
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TREAT SAW: an integrated model of MDMA-assisted therapy and Save A Warrior’s evidence-based practices for holistic healing of complex post-traumatic stress (C-PTS) in California’s returning veterans
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Content
Title Page
TREAT SAW: An Integrated Model of MDMA-Assisted Therapy and Save A Warrior’s
Evidence-Based Practices for Holistic Healing of Complex Post-Traumatic Stress (C-PTS)
in California’s Returning Veterans.
Capstone Project Proposal
Ronald S. Clark, M.B.A.
University of Southern California
Suzanne Dworak-Peck School of Social Work
DSW Program
Dr. Michael Rank
August 2024
2
Table of Contents
I. Abstract ....................................................................................................................... 3
II. Acknowledgements ................................................................................................... 4
III. Positionality Statement ........................................................................................... 5
Executive Summary…………………………………………………………………… 6
IV. Problem of Practice and Literature Review .......................................................... 10
V. Conceptual/Theoretical Framework ....................................................................... 14
VI. Methodology ............................................................................................................ 16
VII. Project Description ................................................................................................ 21
VIII. Implementation Plan ............................................................................................ 25
IX. Evaluation Plan ........................................................................................................ 28
X. Challenges/Limitations .............................................................................................. 31
XI. Conclusions and Implications .................................................................................. 33
Appendix A ...................................................................................................................... 38
Appendix B ...................................................................................................................... 39
Appendix C ...................................................................................................................... 41
Appendix D …………………………………………………………………………….. 43
Appendix E …………………………………………………………………………….. 44
Appendix F …………………………………………………………………………….. 47
References ........................................................................................................................ 49
3
I. Abstract
TREAT SAW is a pioneering initiative addressing the persistent issue of Complex
Post-Traumatic Stress (C-PTS) among California’s returning Veterans. Despite substantial
investments, current treatment modalities have proven inadequate in mitigating the high suicide
rates and deeply-rooted developmental trauma endemic to this population. Funded by Disabled
American Veterans (DAV) with participant referrals from the Grunt Style Foundation (GSF) and
Next Peak: Project Restore Hope, TREAT SAW integrates MDMA-assisted therapy with Save A
Warrior's (SAW) evidence-based practices to offer a comprehensive, holistic solution. The
innovative model focuses on addressing concomitant consequences of adverse childhood
experiences (ACEs), un-integrated survival traits, and unmourned grief (Chartier et al., 2010).
This Capstone Project directly contributes to addressing the Grand Challenge for Social
Work of Closing the Health Gap by developing a novel treatment framework that can be scaled
and adapted to various contexts. It highlights the critical need for policy reform and the
incorporation of evidence-based, alternative therapies in mainstream mental health practices. By
aligning with Design Justice Network Principles, TREAT SAW ensures ethical and equitable
treatment. This initiative represents an innovative step forward, with implications extending
beyond the local context, potentially transforming the national approach to returning Veteran
mental health care.
Keywords: Complex Post-Traumatic Stress, MDMA-assisted therapy, Save A Warrior, Veteran
mental health, design thinking.
4
II. Acknowledgments
I extend my deepest gratitude to all those who have supported and guided me throughout
the journey of this Capstone Project.
First and foremost, I would like to thank Disabled American Veterans (DAV) for their
generous funding and unwavering support. Their commitment to improving the mental health
and well-being of returning Veterans has been the cornerstone of this project.
I am profoundly grateful to my advisor, Dr. Michael Rank, at the University of Southern
California Dworak-Peck School of Social Work. Your guidance, expertise, and encouragement
have been invaluable throughout this process.
A special thank you to the Save A Warrior (SAW) Community of Practice for their
innovative approaches and relentless dedication to supporting returning Veterans and first
responders. Your methodologies and practices have been instrumental in shaping this project.
I would also like to acknowledge the incredible support from my Capstone Peer
Mentoring Team: Dr. Mark Jesinoski, Messrs. Robinson, Carr, and Carlisle. Your feedback,
collaboration, suggested revisions, and steadfast encouragement have been essential in refining
and advancing TREAT SAW.
I would also like to express my heartfelt thanks to Professor Mark Chun of Pepperdine
University for introducing me to the transformative work of the late Dr. Clayton Christensen on
Disruptive Innovation. Your teachings have significantly influenced my approach to this project.
TREAT SAW is dedicated to the memory of those who have served and sacrificed for our
nation. May it contribute to their healing and honor their legacy.
5
III. Positionality Statement:
As a doctoral candidate at the University of Southern California Dworak-Peck School of
Social Work, my positionality is influenced by my identity and lived experiences. I am a
privileged individual, benefiting from access to higher education and resources enabling me to
pursue this critical research. My journey is shaped by a commitment to social justice, particularly
within the returning Veteran community, informed by personal and professional experiences.
Being a white male, I acknowledge the possibility of privileges afforded to me in certain
contexts. This awareness compels me to adopt a reflexive praxis, ensuring that my research and
design processes are inclusive and equitable. My previous geographical background, rooted
primarily in a diverse urban environment, exposed me to various perspectives, enhancing my
understanding of systemic inequalities that affect traditionally marginalized communities.
Theoretical frameworks guiding this project include Design Thinking and Design Justice
principles, which emphasize human-centered and equitable approaches to problem-solving. The
conceptual model of Internal Family Systems (IFS), as developed by Dr. Richard Schwartz, and
the transformative potential of MDMA-assisted therapy, championed by Dr. Rick Doblin,
underpin the therapeutic strategies employed in this project. My commitment to evidence-based
practice is further reinforced by collaboration with organizations such as DAV, GSF, SAW, and
MAPS, which advocate for innovative and effective mental health interventions.
In conducting this research, I am acutely aware of the power dynamics and potential
biases that may influence the design, impacts and outcomes. By maintaining a transparent,
inclusive, and adaptive approach, I aim to contribute meaningfully to the discourse on returning
Veteran mental health, advocating for systemic changes that prioritize holistic and equitable
treatment strategies and methodologies (Clark & Carr, 2022).
6
Executive Summary
a. Description of the Specific Problem and its Connection to a Problem of Practice
and Literature Review
The TREAT SAW project addresses the significant mental health challenges faced by
California’s returning Veterans, specifically focusing on Complex Post-Traumatic Stress
(C-PTS). Despite substantial investments in mental health services, the current treatment
modalities have proven insufficient in mitigating high suicide rates and deep-rooted trauma
within this population. The literature highlights that traditional therapeutic approaches often fail
to address the complex and layered nature of trauma experienced by these individuals, which
includes adverse childhood experiences (ACEs), un-integrated survival traits, and unmourned
grief (Herman, 2015; Figley, 2017; Schwartz, 2001). This project builds on the foundational
work of Judith Lewis Herman, Charles R. Figley, and the innovative therapeutic strategies
proposed by Dr. Rick Doblin and Dr. Richard Schwartz.
b. Connection to the Grand Challenges for Social Work
This Capstone Project directly contributes to the Grand Challenge for Social Work of
Closing the Health Gap. By developing a novel treatment framework that integrates
MDMA-assisted therapy with Save A Warrior's (SAW) evidence-based practices, the project
aims to bridge the gap in mental health services for returning Veterans (Doblin, 2022; Schwartz
et al., 2021). This holistic approach is designed to be scalable and adaptable to various contexts,
highlighting the critical need for policy reform and the incorporation of evidence-based,
alternative therapies in mainstream mental health practices.
c. Design Thinking Methodology and Tools Employed
7
The project employs Design Thinking methodologies, emphasizing empathy, ideation,
prototyping, and iterative testing (Brown, 2008). The design team, comprising returning
Veterans, mental health professionals, and representatives from key stakeholder organizations,
actively engaged in the design process. Through interviews, focus groups, and surveys, the team
gathered insights to define the core problem and develop potential solutions. The high-fidelity
prototype, including a detailed curriculum, service manual, and UX journey map, was iteratively
tested and refined (notionally) based on stakeholder feedback.
d. Theory of Change
The Theory of Change for the TREAT SAW project is built on the following key
questions:
What's the proposed solution trying to achieve?
● The project aims to reduce the suicide rate and improve mental health outcomes
among returning Veterans by addressing the root causes of C-PTS (Doblin, 2022).
How realistic are the project's goals?
● The goals are realistic, given the evidence supporting the efficacy of
MDMA-assisted therapy and SAW’s methodologies. The iterative design process
and stakeholder engagement ensure the solution's practicality and achievability
(Schwartz et al., 2021).
How does the proposed solution work?
● The solution combines MDMA-assisted therapy sessions with SAW’s integrative
intervention techniques. Participants shall undergo a series of therapeutic sessions
in a supportive environment, with data collected to assess outcomes and refine the
approach (Clark & Carr, 2022; Clark, 2023).
8
How does the proposed solution align with best practices?
● The solution aligns with best practices in trauma treatment and MDMA-assisted
therapy, incorporating evidence-based approaches and adhering to ethical
guidelines to ensure safety and efficacy (Doblin, 2022; Schwartz et al., 2021).
e. Professional Significance
The TREAT SAW project is poised to make a significant contribution to the field of
social work by offering an innovative, comprehensive approach to trauma treatment. By
integrating MDMA-assisted therapy with proven methodologies, the project challenges
conventional treatment models and offers a new paradigm for holistic healing. The project's
emphasis on addressing ACEs and un-integrated survival traits provides a framework that can be
adapted to other populations, extending its impact beyond returning Veterans and first responders
(Herman, 2015; Schwartz, 2001).
f. Implementation Plan and Future Action Steps
The implementation plan for the TREAT SAW project includes the following steps:
1. Secure Stakeholder Commitment: Finalize agreements with key stakeholders including
DAV, Grunt Style Foundation, MAPS, and SAW.
2. Legislative Alignment and Ethical Oversight: Ensure compliance with DEA
regulations and obtain necessary approvals for MDMA-assisted therapy (Clark, 2023).
3. Interdisciplinary Curriculum Development: Collaborate with experts to design the
therapeutic curriculum (Schwartz et al., 2021).
4. Resource Allocation: Secure funding and define resources needed for each project
phase (Doblin, 2022).
9
5. Pilot Testing and Data Collection: Conduct a pilot program at Warrior Village
(Hillsboro, Ohio), incorporating iterative improvement mechanisms (Clark & Carr, 2022).
6. Feedback Loops and Iterative Refinement: Create mechanisms for ongoing feedback
from participating returning Veterans and stakeholders (Brown, 2008).
7. Milestone Evaluations: Conduct periodic evaluations to assess progress and make
necessary adjustments (Schwartz, 2001).
8. Publications and Dissemination: Aim to publish findings and present at conferences to
foster awareness and influence policy (Doblin, 2022).
9. Expand and Scale: Prepare to scale the program to other regions, continually refining
the curriculum and therapeutic protocols (Clark & Carr, 2022).
10. Legacy and Knowledge Transfer: Create documentation and training materials to
ensure the program’s insights and methodologies can be easily adopted by other
organizations (Herman, 2015).
10
IV. Problem of Practice and Literature Review
Introduction
In the realm of returning Veterans, a profound existential enigma persists, which can best
be described as “an identity crisis having an identity crisis” (Clark, 2023). With backgrounds
marked by Adverse Childhood Experiences (ACEs) such as neglect, abuse, and family of origin
dysfunction, further exacerbated by the trauma of combat zones and moral injury, a
disproportionate number are left grappling with undiagnosed Complex Post-Traumatic Stress
(C-PTS), depression, anxiety, substance use disorders (SUD), with a default-setting trending
towards self-inflicted deaths of despair (See Infographic; Appendix A).
Grand Challenge for Social Work: Closing the Health Gap
This capstone project addresses the Grand Challenge for Social Work of Closing the
Health Gap (Barth et al, 2022) by focusing on a highly vulnerable population: California’s
returning Veterans. The health gap in question is not merely one of access to services but one of
efficacy and appropriateness of existing therapeutic interventions for C-PTS.
Background and Literature Review
The narrative surrounding returning Veterans and PTSD requires a critical shift to
acknowledge the often-misdiagnosed condition C-PTS. In his ground-breaking work, author Pete
Walker (2014) defines C-PTS as "a more severe form of post-traumatic stress disorder. It is
delineated from this better-known trauma syndrome by five of its most common and troublesome
features: emotional flashbacks, toxic shame, self-abandonment, a vicious inner critic, and social
anxiety" (p. 3). Unlike PTSD, which is typically associated with single or discrete traumatic
events, C-PTS arises from chronic, interpersonal trauma, leading to more intricate symptoms
(Walker, 2014).
11
Walker (2014) elaborates on the characteristics of C-PTS, stating, "Emotional flashbacks
are perhaps the most noticeable and characteristic feature of Cptsd" (p. 3). These flashbacks
manifest not visually but as overwhelming emotional states akin to those experienced during
childhood trauma, distinguishing C-PTS from traditional PTSD. Furthermore, Walker highlights
the severity of C-PTS by noting that "Suicidal ideation is a common phenomenon in Cptsd,
particularly during intense or prolonged flashbacks" (2014, p. 4). This association between
C-PTS and suicidal thoughts points to the urgent need for accurate diagnosis and effective
treatment, especially considering the elevated risks faced by today’s returning Veterans.
Additionally, with respect to the perniciousness of toxic shame, returning Veterans report
their shame is akin to the feeling not that they are doing badly, rather, they themselves are
inherently bad; not that they are inadequate; rather, they are inadequacy (Kurtz, 1994).
While C-PTS is currently not recognized as a distinct diagnosis by the American
Psychological Association (APA), its conceptual framework can be traced back to the pioneering
work of psychiatrist Judith Lewis Herman in her seminal book “Trauma & Recovery” (2015).
Originally published in 1992, Herman's contributions laid the foundation for subsequent
exploration into trauma and its effects on various populations. Charles R. Figley, a prominent
figure in trauma research, notably adapted Herman’s work, focusing on Veteran Family Systems
for Traumatic Stress as documented in Compassion fatigue: Coping with the secondary
traumatic stress disorder in those who treat the traumatized (1995). For purposes of this
capstone proposal, the term C-PTS is used pursuant to a growing recognition and to capture the
nuanced, layered traumatic experiences of California’s returning Veterans.
The Department of Veterans Affairs (VA) and the Department of Defense (DoD) have
conditionally permitted research relating to C-PTS, though treatment protocols predominantly
12
default to PTSD. This capstone aims to close this health gap, offering a comprehensive approach
to addressing the multifaceted challenges faced by this particularly vulnerable population.
Emerging therapeutic approaches provide a well-intended, “fleeting sense of temporary
relief” (De Mello, 1990) for this struggling population. While MDMA-assisted therapy has
heralded promising outcomes (Mitchell et al., 2023), it surfaces an intrinsic limitation — a
misinterpretation around the role of the "ego" (Jung, 2014). Instead of the prevailing belief that
MDMA suppresses the ego, what actually transpires during MDMA’s influence is a temporary
sidelining of the "Manager"; a psychological construct delineated in Schwartz's Internal Family
Systems model (Schwartz, 2021). This transient pause permits the "Exile", another part of one’s
inner psyche bearing one’s core traumas and wounds, to surface. The ultimate objective,
however, should be the reconstitution of a resilient ego, capable of resisting the dictates of an
internalized toxic superego. This superego, with its deeply ingrained negative impositions, often
results in un-integrated survival traits that become maladaptive in adult life (Vaknin, 2007).
Problem of Practice
Despite significant investments, VA has struggled to reduce the suicide rate among
returning Veterans. From 2001 to 2021, the Veteran suicide rate increased by 45.5%, despite a
six-fold increase in the VA's budget (U.S. Department of Veterans Affairs, 2023). Further, a
ProPublica analysis of 313 studies conducted by the agency’s inspector general in recent years
shows repeated failures in behavioral care. A “national disgrace” (per Charles Figley), these
breakdowns have had fatal consequences (Ornstein & Jones, 2015). This capstone project aims
to close the health gap by integrating MDMA-assisted therapy with SAW’s comprehensive
intervention model, addressing the underlying causes of C-PTS in returning Veterans.
13
The true challenge isn’t merely the suppression of the ego; rather, what is holding the
problem in place is the non-cultivation of an ego resilient enough to confront, neutralize, and
transform the debilitating influences of a toxic superego (Vaknin, 2007). This capstone project
asserts that by harmonizing MDMA-assisted therapy with the proven capacity - and critical need
- for SAW's novel “set and setting”, TREAT SAW will not only resolve the underlying symptoms
holding the problem in place (aka “the thing under the thing”); rather, TREAT SAW will
transform the profound underlying conflation in identity - a “voice” still missing from the
conversation - thereby closing the health gap for our returning Veterans and first responders.
Target Population
The target population for this project comprises returning Veterans in California, many of
whom have experienced significant trauma both in their early lives and while in the military.
These individuals are disproportionately affected by C-PTS, depression, anxiety, and SUDs
(Mitchell et al., 2021; Mitchell et al., 2023). Their experiences often include high levels of ACEs
(Clark et al, 2022; Clark, 2023), which have been shown to correlate with increased risk for these
mental health issues (Chartier et al., 2010; Dube et al., 2001; Schulman et al., 2019).
Stakeholder Perspectives
Multiple stakeholders have a vested interest in addressing the problem of C-PTS among
returning Veterans. These include the returning Veterans themselves, their families, mental health
professionals, policymakers, and organizations like the VA and DoD. Returning Veterans often
feel misunderstood and underserved by current treatment modalities, which fail to address the
complex layers of their trauma. Mental health professionals are seeking more effective
interventions, while policymakers are under pressure to reduce returning Veteran suicide rates
and improve mental health outcomes.
14
Solution Landscape
The current solution landscape for addressing C-PTS among returning Veterans includes
a variety of therapeutic approaches, ranging from traditional psychotherapy and
pharmacotherapy to newer, more innovative treatments like the Stellate Ganglion Bloc,
Transcranial Magnetic Stimulation (TMS) as well as MDMA-assisted therapy. However, these
solutions often fail to address the underlying issues of ACEs and un-integrated survival traits.
MDMA-assisted therapy (Mitchell et al., 2021), while promising, often misinterprets the
role of the ego and fails to facilitate the reconstitution of a resilient ego capable of confronting
and neutralizing a toxic superego (Vaknin, 2007). This gap in the solution landscape is where
TREAT SAW aims to intervene, providing a more comprehensive and holistic approach that
integrates the strengths of MDMA-assisted therapy along with the proven methodologies of
SAW (Clark & Carr, 2022)
What is Missing in the Solution Landscape?
Despite the variety of available treatments, there is a significant gap in addressing the
complex and layered nature of C-PTS (Herman, 2015; Walker, 2014). Many existing therapies do
not adequately consider the impact of ACEs, or the necessity of reconstituting a resilient ego.
Additionally, there is a lack of integration between MDMA-assisted therapy and other
therapeutic modalities that can support long-term healing and resilience.
By combining MDMA-assisted therapy with SAW’s evidence-based practices, the
TREAT SAW project aims to close this health gap for returning Veterans. This integrated,
multi-disciplinary approach addresses the root causes of trauma, supports the reconstitution of a
resilient ego, and provides ongoing support for long-term healing and recovery.
V. Conceptual Framework:
15
At the intersection of a myriad of philosophical and therapeutic modalities lies the
compelling ethos of our project. In embracing the depths of Strassman's research on the
psychedelic spectrum, which unravels the intricate layers of human consciousness (Strassman,
2022), and integrating Madsbjerg's insightful elucidation on the art of “optimal grip” - of true
attention in a world rife with distractions - SAW’s “looking lab” (Madsbjerg, 2023) framework
offers an unparalleled tapestry of healing and awareness (Clark & Carr, 2022).
The groundbreaking work of Schwartz on Internal Family Systems posits that for true
healing to manifest, there's a pressing need to navigate and integrate the myriad internal 'parts'
constituting one’s interiority (Schwartz, 2021). By leveraging Schwartz’s transformative model,
Save A Warrior enhances the potential of MDMA-assisted therapy by ensuring concomitant
interventions address not just the physiological wounds; rather, the interventions also resolve
deeply-rooted emotional layers of formative trauma (Clark & Carr, 2022).
Christensen's theory of disruptive innovation reminds us of the need for catalyzing
solutions, urging us to challenge the status quo and consistently push the boundaries of what is
perceived as therapeutic and effective (Christensen, 2006). And yet, as we harness the power of
innovative modalities, we're keenly aware, based on extensive experiential data that
MDMA-assisted therapy, in isolation, does not fully address the depth, breadth and “stuckness”
of trauma's multifaceted intricacies (Clark & Carr, 2022).
Our framework is further enriched by the wisdom of ancient mystics like Rumi and
contemporary psycho-spiritualists like Wayne Dyer and Eckhart Tolle. These influences
underscore the necessity for a holistic (read philosophical versus psychological) approach; an
approach combining cutting-edge research with the possibility of access to timeless wisdom. As
Tolle emphasized, the true transformation occurs when we recognize and transcend the ego (read
16
toxic superego), understanding its true nature and its interplay with what Schwartz identifies as
the "Manager" and the "Exile" (Tolle, 2004; Schwartz, 2021).
The Hero's Journey, as elucidated by Joseph Campbell, is emblematic of the
transformative trajectory Save A Warrior already furnishes for returning Veterans and first
responders during evidence-based interventions at Warrior Village in Hillsboro, Ohio (Campbell,
2008).
And these heroic journeys are not just about navigating the ‘dark night of the soul’;
rather, these journeys are about emerging from liminal space with newfound wisdom and
purpose greater than self that transcends personal pain (Campbell, 2008). SAW’s belief,
grounded in years of experience and interaction with several thousands of trauma survivors, is
that the culmination of this journey requires not just medical or therapeutic intervention; rather,
the journey we speak of requires a genuine, secular spiritual initiation into purposeful servant
leadership (Clark & Carr, 2022).
In essence, our conceptual and theoretical framework isn’t just an amalgamation of
various therapeutic modalities; rather, ours is a harmonious synthesis aimed at creating a holistic
healing journey towards an adult philosophy; a heroic journey that respects the sanctity of each
individual's lived experience, acknowledges the limitations of isolated interventions, and strives
for a comprehensive, transformative experience (Clark & Carr, 2022).
VI. Methodology
Design Thinking
The development of the TREAT SAW project was heavily influenced by the principles
and tools of Design Thinking (What Is, What If, What Wows; What Works). Design Thinking is
a human-centered approach that emphasizes empathy, ideation, prototyping, and iterative testing
17
to solve complex problems (Brown, 2008; Liedtka & Ogilvie, 2011). The design team for this
Capstone project consisted of multidisciplinary members, including returning Veterans, mental
health professionals, filmmakers, policy makers, and representatives from Disabled American
Veterans (DAV), Grunt Style Foundation (GSF) and Next Peak.
Empathy:
The first phase involved deeply understanding the lived experiences and needs of our
target population – returning Veterans. This was achieved through interviews, focus groups, and
surveys. Insights from these interactions highlighted the profound impact of Adverse Childhood
Experiences (ACEs) and the limitations of current therapeutic models in addressing Complex
Post-Traumatic Stress (C-PTS)(Clark & Carr, 2022).
Define:
The insights gathered were used to define the core problem: the need for a holistic and
integrated treatment model that addresses both the psychological and emotional layers of trauma.
This phase also included synthesizing data from existing research, such as the work of Dr. Rick
Doblin on MDMA-assisted therapy and Dr. Richard Schwartz on Internal Family Systems
(Schwartz, 2001; Doblin et al., 2022).
Ideate:
Brainstorming sessions with the design team led to the development of several potential
solutions. The combination of MDMA-assisted therapy with Save A Warrior’s (SAW)
evidence-based practices - and practice-based evidence - emerged as the most promising
approach. The team collaboratively refined this idea, drawing on the diverse expertise of its
members (Clark & Carr, 2022).
Prototype:
18
A high-fidelity prototype was developed, including detailed curriculum modules, a
comprehensive service manual, and a UX journey map. This latter half of the TREAT SAW
prototype was iteratively tested and refined based on feedback from stakeholders, including
returning Veterans, clinicians, and policy makers (Clark & Carr, 2022).
Test:
The SAW prototype portion of TREAT SAW was regularly piloted at Warrior Village in
Hillsboro, Ohio. Real-time data analytics and continuous feedback loops were utilized to assess
the effectiveness of the integrated treatment model and to make iterative improvements.
Design Justice Principles
Design Justice Principles emphasize the importance of equitable and inclusive design
processes that prioritize the needs and voices of marginalized communities (Costanza-Chock,
2020). These principles were integral to the TREAT SAW project.
Community-Led Design (Nothing about Us Without Us):
Returning Veterans were actively involved in every stage of the design process, from
initial ideation to final testing. Their lived experiences and insights were crucial in shaping the
project’s direction and ensuring its relevance and effectiveness (Clark & Carr, 2022).
Equity:
The project specifically addressed the health disparities faced by returning Veterans. By
focusing on this most vulnerable population, the project aimed to close the health gap and
provide equitable access to effective mental health treatments.
Transparency and Accountability:
19
Regular updates and open communication channels were maintained with all
stakeholders, ensuring transparency throughout the project. Feedback was actively sought and
incorporated, fostering a sense of shared ownership and accountability.
Sustainability:
The project is designed with long-term sustainability in mind. The integration of
evidence-based practices with innovative therapeutic approaches ensures that the benefits of the
project can be sustained and scaled over time.
Market Analysis
A comprehensive market analysis was conducted to assess the demand for the TREAT
SAW project relative to alternative options.
Market Demand:
There is a significant and growing need for effective treatments for C-PTS among
returning Veterans. Current treatment modalities often fall short in addressing the complex layers
of trauma experienced by this population. The integration of MDMA-assisted therapy with
SAW’s practices provides a unique and holistic solution that is highly sought after (Clark & Carr,
2022).
Alternative Options:
Existing alternatives include traditional psychotherapy, pharmacotherapy, Stellate
Ganglion Bloc, Transcranial Magnetic Stimulation (TMS), and other psychedelic-assisted
therapies. However, these options often lack the comprehensive, multi-faceted approach of the
TREAT SAW project. The combination of addressing ACEs, un-integrated survival traits, and
the toxic superego makes this project uniquely positioned in the market (Clark & Carr, 2022).
User Acceptance:
20
Feedback from returning Veterans during the testing phase indicated a strong preference
for the integrated treatment model proposed by TREAT SAW. Participants reported significant
improvements in their mental health and a greater sense of support and understanding compared
to traditional therapies (Clark & Carr, 2022).
Funding and Support:
The project has garnered substantial support from key stakeholders, including DAV - and
several other legacy Veteran Service Organizations - further indicating a robust market demand
and the likelihood of successful implementation and scaling.
Additional Methods
Qualitative Research:
In-depth interviews and focus groups were conducted with returning Veterans and mental
health professionals to gather detailed insights into their experiences and needs. This qualitative
data was instrumental in shaping the project’s design and ensuring its relevance and
effectiveness.
Quantitative Research:
Surveys and data analytics were used to measure the impact of the prototype on
participants’ mental health outcomes. This quantitative data provided objective evidence of the
project’s effectiveness and helped identify areas for improvement.
Collaborative Workshops:
Collaborative workshops were held with the design team and stakeholders to brainstorm,
prototype, and test various aspects of the project. These workshops fostered a collaborative and
inclusive design process, ensuring that the project was well-rounded and effective.
Iterative Testing:
21
The prototype underwent multiple rounds of testing and refinement based on feedback
from participants and stakeholders. This iterative approach allowed for continuous improvement
and ensured that the final product was both effective and user-friendly.
VII. Project Description
Building Upon Relevant Policies, Programs, Models, Initiatives, Services, and
Processes
The TREAT SAW project builds upon a robust foundation of relevant policies, programs,
models, initiatives, services, and processes aimed at addressing C-PTS among returning
Veterans. This project aligns with the anticipated rescheduling of MDMA by the DEA in August
2024, which will allow for its use in clinical and holistic settings under strict guidance and
administration. By integrating MDMA-assisted therapy with SAW’s evidence-based practices
and practice-based evidence, the project leverages existing legislative frameworks and enhances
them with innovative therapeutic models (Clark & Carr, 2022).
Contribution to the Grand Challenge for Social Work
The TREAT SAW project directly contributes to the Grand Challenge for Social Work
(GCSW) of Closing the Health Gap (Barth et al., 2022). This initiative aims to bridge the gap in
mental health services for returning Veterans by providing a comprehensive, integrated treatment
model. By addressing the root causes of C-PTS, including ACEs and un-integrated survival
traits, the project offers a holistic approach that is both innovative and scalable (Clark & Carr,
2022) The emphasis on evidence-based practices and stakeholder engagement ensures that the
project aligns with the core objectives of the GCSW.
Design Criteria (See Appendix B for further details)
The design criteria for the TREAT SAW project include the following attributes:
22
1. Holistic Approach: The project integrates multiple therapeutic modalities to address
the complex and layered nature of C-PTS.
2. Human-Centered Design: Returning Veterans and first responders are actively involved
in the design and testing phases to ensure the solution meets their needs.
3. Evidence-Based: The project leverages proven therapeutic practices, including
MDMA-assisted therapy, Narrative Exposure Therapy (Robjant et al., 2010), along with SAW’s
practice-based evidence methodologies (Clark & Carr, 2022).
4. Scalability: The project is designed to be scalable and adaptable to various contexts
and populations.
5. Sustainability: The project includes mechanisms for ongoing support and evaluation to
ensure long-term impact.
Prototype Description
The TREAT SAW prototype comprises a detailed curriculum, comprehensive service
manual, and a UX journey map (See Appendix E). The curriculum includes training modules for
facilitators, therapeutic session guidelines, and data collection tools. The service manual provides
standardized protocols for delivering the integrated treatment model, ensuring consistency and
quality. The UX journey map outlines the participant's experience from initial intake to follow-up
support, highlighting key touchpoints and areas for improvement.
Link to Prototype: [https://www.youtube.com/watch?v=Pxx5pN6RtrA]
Prototype Narrative:
The prototype works by combining MDMA-assisted therapy sessions with SAW’s
integrative intervention techniques. Participants undergo a series of therapeutic sessions in a
supportive and controlled environment. The curriculum includes preparatory sessions,
23
MDMA-assisted therapy sessions, and follow-up integrative sessions. Data is collected
throughout the process to assess outcomes and refine the approach based on real-time feedback.
Theory of Change (ToC)
Proposed Solution Goals:
The primary goal of the TREAT SAW project is to reduce the rate of suicide and improve
mental health outcomes among returning Veterans by addressing the root causes of C-PTS.
Realism of Goals:
The goals are realistic, given the evidence supporting the efficacy of MDMA-assisted
therapy and SAW’s methodologies (Clark & Carr, 2022). The project’s iterative design process
and stakeholder engagement ensure that the solution is both practical and achievable.
How the Solution Works:
The solution works by temporarily disarming the "Manager" part of the psyche through
MDMA-assisted therapy, allowing the "Exile" to emerge and reconnect with the "True Self"
(Schwartz, 2021). This process, followed by SAW’s integrative intervention, fosters long-term
healing and resilience and closes the health gap for returning Veterans (Clark & Carr, 2022).
Alignment with Best Practices:
The proposed solution aligns with best practices in trauma treatment and MDMA-assisted
therapy. It incorporates evidence-based approaches and adheres to ethical guidelines to ensure
safety and efficacy.
Revised Logic Model (See Appendix C for further details)
Resources Needed:
● Funding from DAV and the Grunt Style Foundation et al
● Trained facilitators and clinicians via Next Peak: Project Restore Hope
24
● Therapeutic facilities at Warrior Village and Next Peak (Southern California)
● Data collection and analysis tools
● Ongoing stakeholder engagement
Activities:
● Training facilitators
● Conducting therapeutic sessions
● Collecting and analyzing data
● Providing follow-up support
● Iterative testing and refinement
Desired Results:
● Outputs: Number of participants treated, sessions conducted, data collected
● Outcomes: Improved mental health outcomes, reduced suicide rates, increased
resilience
● Impact: Long-term reduction in C-PTS symptoms, sustainable mental health
improvements
Ethical Considerations
The TREAT SAW project has carefully considered ethical concerns and possible negative
consequences. All therapeutic sessions are conducted under strict guidelines to ensure participant
safety. Informed consent is obtained from all participants, and ongoing support is provided to
address any adverse effects. The project adheres to ethical standards set by relevant regulatory
bodies and incorporates feedback from stakeholders to continuously improve ethical practices.
Likelihood of Success
Success Definition:
25
Success is defined by the project's ability to significantly reduce suicide rates and
improve mental health outcomes among returning Veterans and first responders. This includes
measurable improvements in C-PTS symptoms and increased participant resilience.
Sustainability:
The project is designed to be sustainable through ongoing support and evaluation. By
integrating evidence-based practices and innovative therapeutic approaches, the project ensures
long-term impact and scalability. The support from key stakeholders, including DAV and the
Grunt Style Foundation, further enhances the project’s sustainability and potential for success.
VIII. Implementation Plan
Project Implementation Readiness
The TREAT SAW project is implementation-ready, having undergone extensive planning,
prototyping, and stakeholder engagement. The comprehensive integration of MDMA-assisted
therapy with SAW’s evidence-based practices has been meticulously developed, ensuring all
components are in place for effective execution.
Stakeholder and User Engagement
Ongoing engagement with stakeholders and users is critical to the success of the TREAT
SAW project. Regular updates, feedback loops, and collaborative workshops will be maintained
to ensure continuous alignment with the needs and expectations of returning Veterans and first
responders, as well as key partners.
Context for Testing, Piloting, and Implementation
The TREAT SAW project will be piloted at Warrior Village in Hillsboro, Ohio, a
therapeutic facility equipped to support returning Veterans and first responders. This setting
26
provides a controlled and supportive environment for the integration of MDMA-assisted therapy
and SAW’s methodologies.
Potential/Existing Partners/Collaborators:
● Disabled American Veterans (DAV)
● Grunt Style Foundation (GSF)
● Multidisciplinary Association for Psychedelic Studies (MAPS)
● Next Peak: Project Restore Hope
● Save A Warrior (SAW)
● Veteran Mental Health Leadership Coalition (VMHLC)
● Local healthcare providers and mental health professionals
Line-Item Budget
Item Cost
MDMA Supply and Administration $100,000
Training for Facilitators $50,000
Therapeutic Sessions $200,000
Facility Costs $75,000
Data Collection and Analysis $50,000
Marketing and Outreach $25,000
Miscellaneous Expenses $20,000
Total $520,000
27
Fund Development Plan
The fund development plan focuses on securing diverse funding sources to ensure
financial sustainability and scalability. Key strategies include:
1. Grant Applications: Submit proposals to federal and state grant programs focused on
mental health and returning Veteran services.
2. Corporate Sponsorships: Engage corporations with a vested interest in returning
Veteran mental health initiatives, leveraging existing relationships with DAV and Grunt Style
Foundation et al.
3. Crowdfunding Campaigns: Launch targeted crowdfunding campaigns to raise
awareness and generate public support.
4. Philanthropic Donations: Approach philanthropic organizations and individual donors
with a history of supporting mental health and returning Veteran causes.
Marketing and Brand Plan
Strategies:
1. Brand Development: Develop a cohesive brand identity for TREAT SAW, emphasizing
its innovative approach and commitment to holistic healing.
2. Digital Marketing: Utilize social media platforms, email marketing, and a dedicated
website to reach and engage target audiences.
3. Partnerships: Leverage partnerships with returning Veteran service organizations and
mental health advocacy groups to amplify outreach efforts.
4. Media Engagement: Engage with local and national media outlets to share success
stories and raise awareness about the project’s impact.
Examples:
28
● Social Media Campaigns: Share testimonials from returning Veterans who have benefited
from the program, using hashtags like #TREATSAW and #HolisticHealing.
● Press Releases: Distribute press releases highlighting major milestones, such as the
launch of the pilot program and preliminary results.
● Events and Webinars: Host virtual and in-person events with expert panels to educate the
public and stakeholders about the benefits of MDMA-assisted therapy and SAW’s
methodologies.
IX. Evaluation Plan
Measuring Social Change/Impact
The TREAT SAW project employs a multifaceted approach to measuring social change
and impact. The primary goal is to reduce the rate of suicide and improve mental health
outcomes among returning Veterans. To measure this impact, we will utilize both qualitative and
quantitative evidence:
1. Quantitative Metrics:
● Reduction in suicide rates among participants, measured using the Suicidal Behavior
Questionnaire-Revised (SBQ-R).
● Improvements in mental health outcomes, tracked through standardized assessments such
as the Patient Health Questionnaire-9 (PHQ-9) for depression and the PTSD Checklist for
DSM-5 (PCL-5).
2. Qualitative Metrics:
● Participant feedback collected through structured interviews and focus groups.
● Case studies documenting individual journeys of healing and transformation.
Data Collection Plan
29
The data collection strategy is designed to monitor the effectiveness of the project
continuously and ensure that adjustments can be made as necessary. Key components of the plan
include:
1. Baseline Data Collection:
● Collect baseline data from all participants before the intervention begins, using the
SBQ-R, PHQ-9, PCL-5 assessments and ACEs survey.
2. Ongoing Data Collection:
● Conduct regular assessments at multiple points during the intervention (e.g., after each
therapeutic session) to track progress and identify trends.
● Gather qualitative data through interviews and focus groups conducted at regular
intervals.
3. Post-Intervention Data Collection:
● Collect final assessment data at the conclusion of the intervention and follow up with
participants at 3, 6, and 12 months post-intervention to monitor long-term outcomes.
4. Data Analysis:
● Employ statistical analysis to compare pre- and post-intervention scores, identifying
significant changes and trends.
● Use thematic analysis for qualitative data to uncover common themes and insights.
Communication Plan for Reporting Results/Impact
A comprehensive communication plan will ensure that the results and impact of the
TREAT SAW project are effectively reported to all stakeholders:
1. Regular Updates:
30
● Provide monthly progress reports to key stakeholders, including DAV, GSF, Next Peak
and other partners.
● Share updates through a dedicated project newsletter and website.
2. Interim and Final Reports:
● Prepare detailed interim reports at key milestones (e.g., halfway through the intervention)
and a comprehensive final report at the project's conclusion.
● Include both quantitative and qualitative data in these reports to provide a holistic view of
the project's impact.
3. Presentations and Conferences:
● Present findings at relevant conferences (i.e. MAPS 2025 Psychedelic Conference) and
seminars to disseminate knowledge and engage with the broader mental health and
returning Veteran support communities.
● Host webinars and workshops to share insights and best practices with practitioners and
policymakers.
4. Publications:
● Aim to publish the project's findings in peer-reviewed journals to contribute to the
academic and professional discourse on trauma treatment and mental health.
Formative and Summative Evaluation
Formative Evaluation:
To know the project is successful during its implementation, we will use real-time data
collection and feedback mechanisms. Regular assessments and participant feedback will guide
iterative improvements, ensuring the intervention remains responsive to the needs of California’s
returning Veterans.
31
Summative Evaluation:
Success is defined by measurable reductions in suicide rates and significant
improvements in mental health outcomes among participants. Long-term follow-up data will
provide evidence of sustained impact, validating the efficacy of the integrated treatment model.
Success also includes the project's ability to influence policy and practice, promoting the
adoption of holistic, evidence-based approaches to trauma treatment on a larger scale.
X. Challenges/Limitations
Regulatory Hurdles:
One significant challenge is navigating the regulatory landscape for MDMA-assisted
therapy. Although MDMA is set to be rescheduled by the DEA in August 2024, strict guidelines
and regulations will still govern its use. To address this, through partnerships with DAV et al, the
project will work closely with legal experts and regulatory bodies to ensure full compliance and
secure necessary approvals.
Stigma and Public Perception:
The use of psychedelics in therapy is still stigmatized by some segments of the
population. This stigma could impact participant recruitment and broader acceptance of the
project. To mitigate this, the project will implement an educational campaign aimed at
stakeholders and the public to highlight the evidence-based benefits and safety of
MDMA-assisted therapy.
Resource Allocation:
Securing and allocating resources effectively is crucial. There might be challenges in
obtaining the necessary funding and resources for the project's full implementation. To address
32
this, a diversified fund development plan is in place, including grant applications, corporate
sponsorships, crowdfunding campaigns, and philanthropic donations.
Participant Recruitment and Retention:
Recruiting and retaining participants for the duration of the intervention may pose
challenges. To address this, the project will leverage partnerships with Veteran organizations,
offer comprehensive support services, and create a participant-friendly environment to ensure
high engagement and retention rates.
Data Privacy and Ethical Concerns:
Ensuring data privacy and addressing ethical concerns is paramount. The project will
implement robust data protection measures, including secure data storage and anonymization
protocols, and will adhere to strict ethical guidelines in all research and therapeutic activities.
Logistical Issues:
Logistical challenges, such as coordinating schedules, managing therapeutic sessions, and
ensuring consistent follow-up, can impact the project's effectiveness. To mitigate this, the project
will use advanced scheduling and project management tools to streamline operations and
maintain regular communication with all stakeholders.
Stakeholder Coordination:
Ensuring effective coordination among diverse stakeholders can be challenging. Regular
meetings, clear communication channels, and defined roles and responsibilities will help
maintain alignment and collaboration.
Evaluation and Feedback Integration:
33
Incorporating real-time feedback and making iterative improvements based on participant
and stakeholder input can be complex. The project will employ a continuous feedback loop and
iterative design process, allowing for timely adjustments and enhancements.
Alternative Plans
To address these challenges, the project has developed alternative plans, including:
● Establishing a regulatory compliance task force to navigate legal and regulatory issues.
● Launching a comprehensive public relations campaign to reduce stigma and increase
awareness.
● Diversifying funding sources to ensure financial stability.
● Creating robust participant support systems to enhance recruitment and retention.
● Implementing advanced data protection measures to safeguard participant information.
● Utilizing project management tools to streamline logistics and maintain clear
communication.
● Scheduling regular stakeholder meetings and feedback sessions to ensure ongoing
collaboration and improvement.
By proactively addressing potential challenges and having alternative plans in place, the
TREAT SAW project is well-positioned to navigate obstacles and achieve its goals.
XI. Conclusion and Implications
Conclusion and Innovation
The TREAT SAW project represents a groundbreaking approach to addressing Complex
Post-Traumatic Stress (C-PTS) among California’s returning Veterans. By integrating
MDMA-assisted therapy with Save A Warrior's (SAW) evidence-based practices, the project
aims to close the health gap in current mental health services. This innovative, comprehensive
34
approach is designed not only to alleviate symptoms; rather, this approach also addresses the root
causes of trauma, offering a holistic path to healing. The project leverages the anticipated
rescheduling of MDMA by the DEA, positioning itself at the forefront of modern therapeutic
practices. With robust stakeholder engagement, rigorous evaluation methods, and a clear plan for
sustainability, TREAT SAW is poised to make a significant impact on the mental health and
well-being of California’s returning Veterans.
Lessons Learned
Throughout the collaborative problem-solving and design thinking process, several
critical lessons emerged. Firstly, the importance of stakeholder engagement became evident. By
involving California’s returning Veterans and mental health professionals in the design process,
the project was able to create a more user-centered and effective intervention. Secondly, the
iterative nature of the design thinking process allowed for continuous refinement and
improvement, ensuring that the project remained responsive to the needs of its target population.
Lastly, the integration of diverse therapeutic modalities highlighted the necessity of a
multifaceted approach to trauma treatment, addressing not only the symptoms; rather, also the
underlying causes of C-PTS.
Implications for Practice and Future Use
The TREAT SAW project has significant implications for practice and the broader mental
health ecosystem. By demonstrating the efficacy of combining MDMA-assisted therapy with
SAW’s integrative methodologies, the project challenges conventional trauma treatment models
and offers a new paradigm for holistic healing. The success of this project could lead to broader
acceptance and integration of MDMA-assisted therapies in clinical settings, potentially
transforming mental health treatment practices. Additionally, the project’s emphasis on
35
addressing adverse childhood experiences (ACEs) and un-integrated survival traits provides a
framework for other interventions aimed at similar populations, extending its impact far beyond
California’s returning Veterans.
Action Plan
To advance the next steps and ensure the successful implementation of the TREAT SAW
project, the following concrete plan has been developed:
1. Secure Stakeholder Commitment:
● Finalize agreements with key stakeholders including DAV, Grunt Style
Foundation, MAPS, Next Peak: Project Restore Hope and SAW.
● Establish a steering committee with representatives from each organization to
oversee project implementation and progress.
2. Legislative Alignment and Ethical Oversight:
● Ensure compliance with DEA regulations and obtain necessary approvals for
MDMA-assisted therapy.
● Engage legal and ethical advisors to navigate regulatory requirements and
maintain ethical standards.
3. Interdisciplinary Curriculum Development:
● Collaborate with experts like Dr. Rick Doblin and Dr. Richard Schwartz et al to
design/refine the therapeutic curriculum.
● Incorporate training modules for facilitators, therapeutic session guidelines, and
data collection tools.
4. Resource Allocation:
36
● Define the resources needed for each project phase, from planning to execution to
follow-up.
● Secure funding through diversified sources including grants, corporate
sponsorships, and crowdfunding campaigns.
5. Pilot Testing and Data Collection:
● Conduct a pilot program at Warrior Village in Hillsboro, Ohio, incorporating
iterative improvement mechanisms.
● Use real-time data analytics to assess the effectiveness of the therapeutic
modalities.
6. Feedback Loops and Iterative Refinement:
● Create built-in mechanisms for ongoing feedback from participants and
stakeholders.
● Incorporate feedback into iterative design loops for continuous program
enhancement.
7. Milestone Evaluations:
● Conduct periodic evaluations at critical milestones to assess progress and make
necessary adjustments.
● Share interim reports with stakeholders to maintain transparency and
accountability.
8. Publications and Dissemination:
● Aim to publish findings in reputable journals and present at conferences to foster
greater awareness and influence policy.
37
● Produce accessible formats like blog posts or podcasts to reach a broader
audience.
9. Expand and Scale:
● Using insights from the pilot, prepare to scale the program to other regions.
● Continuously refine the curriculum and therapeutic protocols based on real-world
outcomes.
10. Legacy and Knowledge Transfer:
● Create documentation and training materials to ensure the program’s insights and
methodologies can be easily adopted by other organizations.
● Establish a sustainable Community of Practice (CoP) and Center of Excellence
(CoE) for ongoing support, learning, and development of best practices.
By following this comprehensive action plan, the TREAT SAW project aims to ensure
successful implementation, continuous improvement, and sustainable impact, ultimately closing
the health gap for California’s returning Veterans.
38
Appendix A: Adverse Childhood Experiences (ACEs) Infographic
*Source: http://www.cdc.gov/ace/prevalence.htm
39
Appendix B: Design Criteria
CRITERIA WIDER OPPORTUNITY SPACE
MUST
The design must address the needs of
returning Veterans, including dealing
with complex post-traumatic stress
(C-PTS), adverse childhood experiences
(ACEs), and the integration of
MDMA-assisted therapy with traditional
therapeutic practices.
Design interventions that promote holistic healing,
provide mental health resources, and foster a
culture of openness and support around trauma
and mental health issues for returning Veterans.
COULD
The design could incorporate
evidence-based interventions like
Internal Family Systems (IFS), Narrative
Exposure Therapy (NET), and other
trauma-informed therapies.
Develop platforms or programs that facilitate
access to these interventions, such as integrative
therapy sessions, community support groups, or
digital resources for ongoing support.
SHOULD
The design should involve a
multi-pronged approach, including
individual support, organizational
changes, and digital technologies.
Consider the role of social workers,
Veterans' organizations, and
interdisciplinary teams.
Implement policies that promote mental well-being
at the organizational level, such as creating
trauma-informed care environments, providing
mental health training, and establishing support
networks. Leverage digital technologies to
provide continuous support and resources.
40
WON’T
The design won’t rely solely on
traditional medical models or short-term
solutions. The design won't ignore
underlying social, cultural, and
institutional factors.
Explore alternative solutions that address the root
causes of the problem, such as improving mental
health literacy, fostering a culture of acceptance
and support, and addressing systemic issues that
contribute to trauma and mental health
challenges.
41
Appendix C: Revised Capstone Logic Model
42
Appendix D: TREAT SAW Journey Map (text-based)
Onboarding:
● User Registration and Profile Setup: Participants register for the program and
create their profiles, providing necessary personal and medical information.
● Initial Assessment: Participants undergo an initial assessment to evaluate their
mental health status, ACE scores, and specific needs.
● Introduction to the Program: Participants receive an orientation that explains the
program's structure, goals, and available resources.
Engagement:
● Participation in Therapeutic Modules: Participants engage in therapeutic sessions
based on Internal Family Systems (IFS), Narrative Exposure Therapy (NET), and
other trauma-informed approaches.
● Accessing Support and Resources: Participants have access to a comprehensive
library of educational materials on trauma, mental health, and holistic healing
practices.
● Community and Peer Support: Participants join discussion forums, support
groups, and live chat sessions with trained facilitators and fellow participants.
Progress Tracking:
● Regular Check-ins and Feedback Sessions: Participants have regular check-ins
with facilitators to discuss their progress, challenges, and goals.
● Tracking Progress: Participants use tools provided by the program to track their
progress, set goals, and receive personalized feedback.
Completion:
43
● Final Assessment and Reflection: Participants undergo a final assessment to
evaluate their progress and reflect on their journey.
● Transition to Ongoing Support and Resources: Participants receive guidance on
transitioning to ongoing support and resources available post-program.
● Continued Engagement and Community Involvement: Participants have
opportunities to remain engaged with the community through continued
participation in support groups and forums.
44
Appendix E: TREAT SAW User Experience (UX) Map
Welcome and Orientation:
● Warm Reception: Participants are welcomed by the staff and given a tour of the
facility. This initial interaction is designed to create a comfortable and welcoming
atmosphere.
● Orientation Session: An introductory session is held to familiarize participants
with the program structure, goals, and resources available to them.
Therapeutic Sessions:
● Structured Sessions: Participants attend scheduled therapeutic sessions based on
Internal Family Systems (IFS), Narrative Exposure Therapy (NET), and other
trauma-informed approaches. These sessions are facilitated by trained
professionals.
● Interactive Activities: Sessions include a mix of individual and group activities,
such as role-playing, guided meditations, and creative expression exercises to
enhance engagement and learning.
Support and Resources:
● Resource Center: A dedicated resource center within the facility provides
educational materials on trauma, mental health, and holistic healing practices.
Participants can access books, articles, and multimedia resources.
● On-site Counseling: Professional counselors are available for one-on-one sessions
to provide personalized support and guidance.
Community Building:
45
● Group Discussions: Regular group discussion sessions are held, allowing
participants to share their experiences, challenges, and successes. This fosters a
sense of community and (certified) peer support.
● Social Activities: Organized social activities, such as group meals, outdoor
excursions, and recreational events, help build camaraderie and mutual support
among participants.
Feedback and Progress Tracking:
● Check-in Meetings: Participants have regular check-in meetings with facilitators
to discuss their progress, set goals, and address any concerns. These meetings
provide an opportunity for personalized feedback and adjustments to the
therapeutic plan.
● Progress Journals: Participants are encouraged to keep personal journals to track
their thoughts, feelings, and progress throughout the program. Facilitators review
these journals during check-ins.
Completion and Follow-Up:
● Final Assessment: A comprehensive assessment is conducted at the end of the
program to evaluate each participant's progress and outcomes.
● Graduation Ceremony: A closing ceremony is held to celebrate the participants'
journey and achievements. Participants receive certificates of completion and are
encouraged to share their experiences and reflections.
● Transition Plan: Participants work with facilitators to develop a transition plan for
maintaining their progress and accessing ongoing support after the program.
Ongoing Support:
46
● Alumni Network: Graduates of the program are invited to join an alumni network,
providing continued access to support groups, resources, and events.
● Follow-up Sessions: Periodic follow-up sessions are scheduled to check in on
participants' progress and offer additional support as needed.
Facility Design:
● Comfortable Environment: The facility is designed to be a safe, comfortable, and
therapeutic space. It includes private counseling rooms, group activity spaces, and
relaxing common areas.
● Healing Spaces: Outdoor areas, such as gardens, labyrinths and walking paths, are
available for participants to use for reflection and relaxation.
Data Collection and Analysis:
● Confidential Feedback: Participants provide confidential feedback on their
experience and the program's effectiveness. This feedback is used to continually
improve the program.
● Outcome Tracking: Data on participant outcomes is collected and analyzed to
assess the program's impact and identify areas for improvement.
Ethical Considerations:
● Confidentiality: Strict confidentiality protocols are in place to protect participants'
privacy and personal information.
● Informed Consent: Participants are fully informed about the program's activities
and provide consent before participating in any therapeutic sessions or data
collection.
47
Appendix F: About the Organizations
Disabled American Veterans (DAV) Website: [https://www.dav.org/](https://www.dav.org/)
DAV is a nonprofit charity that provides lifetime support for Veterans across all generations and
their families. Established in 1920, DAV offers annual assistance to over one million Veterans,
helping them gain access to the benefits they've earned and providing additional services like
transportation and job resources.
Grunt Style Foundation (GSF) Website:
[https://www.gruntstylefoundation.org/about](https://www.gruntstylefoundation.org/about)
Established in April of 2021, Grunt Style Foundation is a national nonprofit organization
committed to providing life-changing resources and experiences for service members, returning
Veterans, and their families. With a steadfast commitment to its core values—Mental Health and
Wellness, Transition and Sustainment, Food Insecurities, and Homelessness–Grunt Style
Foundation offers those who served and continue to serve our country their due recognition,
honor, and support.
Multidisciplinary Association for Psychedelic Studies (MAPS) Website:
[https://maps.org/](https://maps.org/)
MAPS was founded in 1986 and is a 501(c)(3) nonprofit research and educational organization.
It aims to establish medical, legal, and cultural contexts in which people can benefit from the
careful uses of psychedelics and marijuana. MAPS has been a key player in the renaissance of
psychedelic research and is pushing for FDA-approved treatments.
48
Next Peak Website: [https://nextpeak.org/](https://nextpeak.org)
"Next Peak - Project Restore Hope" is a visionary initiative designed to breathe new life into
Veteran of Foreign Wars (VFW) facilities across America, starting with the transformation of
VFW Post 5431 in Solana Beach, California. At its core, the project seeks to address the pressing
needs of returning combat Veterans, particularly considering the current backlog within the VA
medical system. By converting these spaces into integrative holistic healing centers, the aim is to
provide a wide array of accessible therapies and support services, ranging from mental health
counseling to physical rehabilitation programs.
Save A Warrior (SAW) Website: [https://saveawarrior.org/](https://saveawarrior.org/)
Save A Warrior offers a powerful healing experience for active-duty military, returning Veterans,
and first responders suffering from post-traumatic stress. Since its launch in 2012, SAW has
dedicated itself to combating the devastating rates of suicide among warriors. Their 72-hour
intensive program focuses on integrative methods designed to enact transformative changes.
Veteran Mental Health Leadership Coalition (VMHLC) Website: www.vmhlc.org
A coalition of Veteran-led organizations, VMHLC’s mission is to lead in the fight to prevent
suicide and deaths of despair - not only for Veterans - but for all Americans - through increased
access to safe and affordable psychedelic-assisted therapy.
Together, these organizations contribute a diverse array of skills, experiences, and
resources to this Capstone Project, all aimed at revolutionizing the treatment of Complex PTSD
in California’s returning Veterans and, in doing so, close the health gap.
49
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Abstract (if available)
Abstract
TREAT SAW is a pioneering initiative addressing the persistent issue of Complex Post-Traumatic Stress among California’s returning Veterans. Despite substantial investments, current treatment modalities have proven inadequate in mitigating the high suicide rates and deeply-rooted developmental trauma endemic to this population. Funded by Disabled American Veterans with participant referrals from the Grunt Style Foundation and Next Peak: Project Restore Hope, TREAT SAW integrates MDMA-assisted therapy with Save A Warrior's evidence-based practices to offer a comprehensive, holistic solution. The innovative model focuses on addressing concomitant consequences of adverse childhood experiences (ACEs), un-integrated survival traits, and unmourned grief.
This Capstone Project directly contributes to addressing the Grand Challenge for Social Work of Closing the Health Gap by developing a novel treatment framework that can be scaled and adapted to various contexts. It highlights the critical need for policy reform and the incorporation of evidence-based, alternative therapies in mainstream mental health practices. By aligning with Design Justice Network Principles, TREAT SAW ensures ethical and equitable treatment. This initiative represents an innovative step forward, with implications extending beyond the local context, potentially transforming the national approach to returning Veteran mental health care.
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Asset Metadata
Creator
Clark, Ronald Scott
(author)
Core Title
TREAT SAW: an integrated model of MDMA-assisted therapy and Save A Warrior’s evidence-based practices for holistic healing of complex post-traumatic stress (C-PTS) in California’s returning veterans
School
Suzanne Dworak-Peck School of Social Work
Degree
Doctor of Social Work
Degree Program
Social Work
Degree Conferral Date
2024-08
Publication Date
07/22/2024
Defense Date
07/18/2024
Publisher
Los Angeles, California
(original),
University of Southern California
(original),
University of Southern California. Libraries
(digital)
Tag
complex post-traumatic stress,design thinking,MDMA-assisted therapy,OAI-PMH Harvest,Save A Warrior,veteran mental health
Format
theses
(aat)
Language
English
Contributor
Electronically uploaded by the author
(provenance)
Advisor
Rank, Michael (
committee chair
), Jesinoski, Mark (
committee member
), Robinson, Todd (
committee member
)
Creator Email
rjclark@usc.edu,rscjake@gmail.com
Permanent Link (DOI)
https://doi.org/10.25549/usctheses-oUC113998FYJ
Unique identifier
UC113998FYJ
Identifier
etd-ClarkRonal-13271.pdf (filename)
Legacy Identifier
etd-ClarkRonal-13271
Document Type
Capstone project
Format
theses (aat)
Rights
Clark, Ronald Scott
Internet Media Type
application/pdf
Type
texts
Source
20240730-usctheses-batch-1186
(batch),
University of Southern California
(contributing entity),
University of Southern California Dissertations and Theses
(collection)
Access Conditions
The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright.
Repository Name
University of Southern California Digital Library
Repository Location
USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA
Repository Email
cisadmin@lib.usc.edu
Tags
complex post-traumatic stress
design thinking
MDMA-assisted therapy
Save A Warrior
veteran mental health