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The U.S. Department of Veterans Affairs called on innovators to develop suicide prevention solutions that meet the diverse needs of Veterans. They offered millions in prizes for those offering the most effective solutions to stopping veteran suicide. We threw our hat in the ring!
While The Liberty Projects didn't make the final selection, we thought it important to show our supporters more detail on what we do and why we do it.
We were disappointed that the committee chose a overwhelming selection of digital and artificial intelligence (AI) options in their awards. In our personal experience with veterans, hands on solutions are more effective and vital towards achieving a reduction in suicide rates among our veterans.
We wish them luck in their endeavors.
Mission Daybreak
Overview of The Liberty Projects Programs
The Liberty Projects Inc. (TLP) is a 501c3 (IRS letter in appendix) that provides alternative solutions to prevent and end Veteran Suicide. We offer four distinct programs in addition to the serenity and value of the Ranch itself, creating more than just a treatment program but a community where people come to heal but stay to help. Our goal is to support and grow the veterans’ emotional, cognitive, social, physical and educational wellbeing through our programs and invitation into our ranch community. We believe part of the healing process is not done during therapy sessions, but done while experiencing life, alone and with others. At the ranch, we provide a safe, nonjudgmental space where veterans of all shapes and sizes are welcome to engage in our programs or just relax in and around the nature at the ranch. As a result, our veterans have experienced increased self-esteem, self-worth, trust for others and community integration.
Why we like Alternative Methods
The brain organizes information different than the body does. All the insight in the world will not change the body’s natural response to trauma. Intellect does not necessarily prevent triggers and does not guarantee change. Talk therapy aims to change the maladaptive thoughts and negative beliefs associated with the trauma without really processing the state specific images, emotions, and body sensations which accompany trauma recall. We know that not all veterans have the same needs or the same PTSD symptoms, and no one approach works for everyone.
We utilize the ranch as a holistic safe haven for support, growth, and plain old relaxation. Our veterans look forward to participating and keep coming back, so dropouts are minimal. We have found that our programs have helped veterans to find more internal resources than they knew they had, strengthen coping skills, practice asking for and receiving help, and begin to regain a sense of control. This growth and healing occur within an environment free from unrealistic expectations, judgement, and pressure.
Who We Serve
TLP is open to any veteran; however, our target audience is veterans who are physically active, between 25-60 years old, typically considered “loners” or socially isolated, and who have a willingness to participate. We work with local organizations, 22 Warriors and Merging Vets and Players (MVP) to find participants. We were recently asked by the local VA if we could take more veterans, however, we are currently at capacity and have put many on a waitlist.
Equine Assisted Therapy
Much of a traumatic experience simply cannot be verbalized or explained with words—equine assisted therapy allows for real-time feedback about what does and does not work while interacting with the horses. Equine therapy gives veterans the opportunity to try new communication methods with a partner without an agenda.
Horses use their awareness to see a threat, identify it, react to the threat and then go back to grazing. Our goal is to help veterans do the same thing – acknowledge that the threat existed and then get back to their lives. It takes time to change the way veterans think about themselves and others, but the horses show them where to start. Because of their own hypervigilance, veterans with PTSD easily understand and can relate to the trust and hypervigilance in a horse.
We offer structured horsemanship training in 8-week sessions, with lessons 4-6 times per week. These lessons are taught by an equestrian professional and involve unmounted work with the horse which incorporates touch, environment, and a strong necessity to build a relationship with the horse through communication skills. Veterans learn about horse safety, horse anatomy, breed differences, body language, leading, grooming, riding, principles of communicating with the horse, communicating through pressure points, judging and much more. Veterans are also invited to participate in horseback riding in with the trainer or in a group setting.
Veteran Impact
The program is designed to provide veterans with an emotionally safe, nonjudgmental animal interaction experience. Some veterans will benefit from just being around the horse, others will seek to enhance and hone their horsemanship skills.
Interacting with the horses promotes awareness of body language of the horse and the veterans themselves. The outcome of many of these interactions is an increase in their self-awareness, body language, and the correlation between your mood and your body language. Many veterans begin the program distant and cautious, not knowing what to expect. By the end of the first few lessons, a bond begins to form between the veteran and the horse, creating a desire to continue the work and learn new skills while increasing their bond.
After day 2 of his EAT, an Army Special Forces veteran told our ranch manager, “The shocking thing was how much the horse had retained in the training. The horse knew what I was about to do just by looking at him. I can’t wait to see what he is going to do tomorrow!”
The shared behaviors between mustangs and veterans, from being oversensitive, easily startled, and hypervigilant to danger, mean healing can come from a common ground that another human may not be able to give, especially not in a traditional setting. Through bonding with the horses, the veterans have something to look forward to, a reason to stay engaged, and live to see another day. The goal of this program is to give veterans more than just hope for a better tomorrow, give them experience of a better tomorrow.
Evidence Samples about Equine Therapy Study with Veterans
Many medical, military, and veteran advocate groups continue to acknowledge that Equine Assisted Therapy is substantially beneficial for our veterans.
In late 2021, the Man O’ War project, with the Columbia University Irving Medical Center, published the findings of the first university-led study to evaluate equine-assisted therapy in treating veterans with PTSD in the Journal of Clinical Psychology. [1] The study found that equine therapy had positive results with veterans suffering from PTSD. “Through horse-human interaction, veterans can relearn how to recognize their feelings, regulate emotions, and better communicate, as well as build trust and come to trust themselves again—all valuable tools to help them succeed with family, work, and social relationships,” Dr. Fisher said. [2]
Lanning and Krenek investigated the outcomes of an equine-assisted activities program for 13 veteran participants.[3] Participants had common themes of “hopelessness”, “need for healing”, “isolation”, and “depression.” After participating in the program, themes of “increased sociability”, “reduced feelings of isolation”, “increased sense of trust and hope”, and “increased need to serve others” were noted. Participants reported less physical and emotional limitations, and also experienced a reduction in depression symptoms over time.[4]
[1] https://www.psychiatrist.com/jcp/trauma/equine-assisted-therapy-posttraumatic-stress-disorder-military-veterans-open-trial/
[2] https://www.columbiapsychiatry.org/news/horse-therapy-helps-veterans-overcome-trauma
Native American Sweat Lodge
While conventional clinical PTSD therapy focuses on nerves, triggers, and learning to silence inappropriate reactions to stimuli, the sweat lodge approach identifies a different source of suffering. Emphasis is placed on the tumult that comes from fighting people. Both in society and in war, we experience antagonistic relationships with other people and these experiences make us suffer. This concept applies to all facets of life, not just on the battlefield.
To offer PTSD patients alternatives to medication, a handful of VA hospitals and military bases have supported sweat lodge ceremonies over the last 20 years. The Liberty Projects hosts six “sweats” each year at a sacred location near the Shiloh Ranch. Currently, the sweats are reserved for veterans and active duty only. The ceremonies are led by Pauite elders who are military veterans. The sweats accommodate 20 people, run approximately four hours and weave together prayers, songs, teachings, herbs, and restoring one’s sense of connection to the people, places, and spirits around them.
Veteran Impact
Elders focus on learning from horrific experiences—not carrying guilt and self-hate about one’s past actions. They emphasize moving on to become better people who do not harm others. Faced directly, the experience of being afflicted with one’s own violence is understood, and attendees are accepted with a kind of guaranteed belonging that is unlike anything else. A sincere, radical belonging is virtually promised to attendees provided they respect and adhere to the ritual decorum of the sacred grounds.
As veterans who distinguish themselves from civilians, some may perceive their postwar suffering to be exclusive to their situation. Some veterans are attracted to the ceremonies for this very reason. But what unfolds surpasses their preconceptions as the ceremony escorts veterans through something deeper and potentially more challenging than traditional therapy. For two years, TLP has hosted many sweats, and each time, numerous veterans have described a sense of community, belonging, and acceptance. Demand for additional sweats is high, and each sweat has a full attendance. This not only speaks to the efficacy of the approach, but the intensity of the outcome for the participants.
The goal of this program is to create that sense of nonjudgmental community, where veterans have a place to go, or people who can relate, rather than feeling isolated and misunderstood. We do not just tell the veterans we accept them; we show them. Anonymous special forces MMA fighter, with tears in his eyes at the end of the sweat confides in Mr. Hoffman, “that was the best day I have had since I left the army.”
Evidence of Efficacy
The U.S. Veterans Administration has recognized the value of sweats to service members, and since the 1990s, has allowed them to conduct sweats at several VA medical centers across the country. Today, many military sites incorporate sweats as part of their PTSD treatment, including the Salt Lake VAMC and the Sheridan VAMC as part of the VA’s Whole Health program. Other noteworthy locations participating in sweats include American Lake VAMC, Fort Carson Army Base, and Spokane VAMC.
Since PTSD is specific to the individual, there is no concrete rubric to compare progress against. The goal of many of these programs is to assist the veteran in reintegration with civilian life/culture and not get lost in the discordance of post-war trauma. If these sweats are able to provide veterans with an outlet for their buried emotional pain, a community that understands them and bonds with them, and a path forward to regular social interaction, then this approach has accomplished the underlying intention of preventing veteran suicide.[1]
“Because it’s such a structured form of therapy, [and] these guys are used to that structure, it’s a way for them to really put things in perspective,” adds Shella Stovall, the associate director of patient care at the Salt Lake City VA.[2]
“Really when we talk about Whole Health at the VA, we’re looking at providing a holistic approach to care that puts the patient at the center of their healthcare and makes them the captain of their healthcare team. […] Whole Health addresses every part of a veteran’s life, including rest, nutrition, physical activity, surroundings, relationships and spirituality. […] The approach has led to a cultural transformation within the entire VA healthcare system.” according to Sheridan VA Healthcare System’s Whole Health Manager Esther Reece.[3]
[1] https://coloradosph.cuanschutz.edu/docs/librariesprovider205/journal_files/vol6/6_3_1995_1_scurfield. pdf?sfvrsn=d885e2b9_2
[2] https://www.neh.gov/humanities/2015/januaryfebruary/statement/healing-spaces
[3] https://www.wyomingpublicmedia.org/open-spaces/2020-02-21/sheridan-va-health-system-makes-space-for-native-american-traditions-in-healing; https://wyofile.com/sheridan-va-employs-sweat-ceremonies-in-whole-health-program/; https://www.thesheridanpress.com/news/local/sheridan-va-employs-sweat-ceremonies-in-holistic-health-program/article_e582ce88-2a67-5ec7-9fd3-1d91a973f0ec.html
VA Claim Medical Exam Support
At TLP we understand that the VA recommends working with a Veterans Service Officer (VSO) to help guide veterans through the claims process. We also understand that this can be an incredibly difficult process for some veterans and are eager to assist. We work with veterans and/or their VSO to help ease some of the administrative stress of this process. Our staff will assist in the preparation of all paperwork and documentation to ensure information is complete and organized in a manner that ensures the timeliest responses back from the VA.
Additionally, we review expectations, timelines, etiquette, and other aspects of the evaluation process. Our volunteers work with the veterans to understand their unique situation and help role-play the various scenarios that can occur during the evaluation. Our staff provide support through transport to the appointment and waiting in the lobby. Although we cannot be present in the exam room, we want the veterans to know that they have value, and we will happily wait a few feet away for them to finish. After the appointment ends, we encourage the veterans to stay at the Ranch for a day or two; as re-living traumatic events tend to have an effect on our moods and ability to interact with others. While at the Ranch, these veterans are welcome to interact with horses, participate in a sweat (if available) or relax and enjoy the tranquil scenery.
Veteran Impact
Many veterans do not see the exams or this process as a positive activity. We are there to support the veteran as they discuss their condition with a stranger. Whether a veteran may over-emphasize or minimize their pain or condition, we provide an ear, a shoulder, experience, and acceptance. This is a scary process for many, and the outcome typically has an affect on what life will look like for the veteran in the years to come.
Through education, documentation assistance, role-playing, and physical attendance, veterans do not need to go through this alone. Knowing that others have gone through it, gotten denied, had flashbacks, gotten angry, etc… reminds veterans that we are all human and their reactions are normal. Social support is pivotal in demonstrating to veterans that they have value and a place of belonging even while they are experiencing a new form of trauma.
Despite dealing with mental stressors like PTSD, many combat-wounded veterans have physical ailments to contend with. Regardless of how a veteran may feel about his/her service, the extent of their injury, or the impact it has on their lives, many veterans internalize the pain, the stereotypes, and the outcome of these processes.
One family member of a service-disabled veteran reached out to us in desperation because her brother came home after a day of exams and completely shut down and shut everyone out for four days. Her entire family was worried that he was suicidal, and she was desperate to help him. He made it through those days, but barely. We spoke with him a few days later. We shared our experiences, offered our help for the next round, and provided a community that truly understood the trauma of explaining service-related pain. After his second round of exams, he told us, “I don’t want to talk about it, you know it was rough, but it means a lot that someone out there can relate, and I am not alone.”
Evidence of Efficacy
The benefits of having and using personal support systems include reduced stress, decreased physical health problems, and improved emotional well-being. The feeling of belonging can be incredibly important when it comes to having a healthy, functioning life. Lack of it can lead to isolation, depression and potentially suicide. Various studies have concluded that veterans’ mental health is positively correlated with social support.
In 2017, Military Behavioral Health published a study demonstrating, “veterans who were in the high social support group had lower lifetime depression, lower likelihood of lifetime suicide ideation, and lower rates of lifetime mental health service use. […] High social capital was related to lower lifetime suicide ideation and lower alcohol misuse.”[1]
In 2021, the Boston University School of Medicine published findings that, “Although prior research has examined the role that depression, social support and psychological resilience play in U.S. veterans’ post-military mental health and functioning, this study provides new insight into how these factors work together to impact veterans’ well-being. “The fact that the worst well-being was reported by veterans with high depression and low social support underscores the particularly important role that the combination of these two factors are likely to play in veterans’ post-military well-being. Moreover, the finding that higher psychological resilience moderated the impact of depression on veterans’ well-being suggests that those individuals who are most resilient may be better able to cope with depression when it is experienced.”[2]
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663244/
[2] https://www.bumc.bu.edu/busm/2021/02/17/veterans-depression-social-support-and-psychological-resilience-as-they-leave-service-play-a-substantial-role-in-their-later-well-being/; https://iaap-journals.onlinelibrary.wiley.com/doi/10.1111/aphw.12252
BrainPaint Neurofeedback
With dedicated offices on-site, veterans are in a private, climate-controlled area. They begin with a 90-question symptom assessment administered by a BrainPaint technician, who then evaluates the results to identify parts of the brain that may be under-aroused. During a typical session, the BrainPaint technician applies EEG sensors on the scalp that pick up electrical signals of different frequencies and wavelengths. The sensors may be adjusted 1-3 times during a 30-minute session.
During this time, the veterans listen to audio tracks, and watch fractal visuals on a computer screen. BrainPaint aims to identify the types of patterns and music that induce a relaxed state, and then to reproduce (or “paint”) them by practicing becoming calm. Veterans ideally learn how to activate certain centers of the brain that may be under-stimulated. Protocols are updated as the veteran makes progress over time. The program takes between 45 and 60 sessions to complete.
Veteran Impact
Traditionally, talk therapy (cognitive behavior therapy) is used to treat veterans with PTSD. Consequently, many veterans do not want to talk about the trauma, relive the trauma, or even acknowledge the trauma. “Trauma-focused” talk therapy can be helpful in many ways, such as validating emotions and helping veterans realize that they are not to blame for what happened. Unfortunately, the therapy focuses on your memory of the traumatic event or what it means to you; exactly what many veterans try to avoid.
However, trauma is stored in deeper parts of the brain and nervous system as whole-body experiences, not just linear narratives. This means that patients do not just remember what happened as a coherent story; they also remember how they felt and how their bodies reacted. They remember how scared they were, as well as their racing heart and difficulty breathing. Talk therapy often cannot address these emotional and physical memories of trauma that have become ingrained in the body’s biology.
We have found that providing access to BrainPaint neurofeedback allows veterans a chance to realign their brains without having to talk about it or rehash memories. Many of our veterans who have declined talk therapy have approached BrainPaint with hope and excitement. The goal of trauma-focused neurofeedback is to help veterans shift from a hyper-aroused state to a calmer one so that they can experience a sense of safety and react more appropriately to everyday events.
Evidence Framework
Despite current veteran viewpoints on talk therapy, it is still the preferred first line of therapy for many institutions. Unfortunately, many veterans would rather not participate at all, then go through a traditional therapy session. Research has shown that for veterans, talk therapy is not very successful and many drop out; thus, creating a negative overall perception to getting help.
The guidelines and strong research evidence suggest that Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and trauma-focused Cognitive Behavioral Therapy (CBT) should be the first line of treatment for PTSD whenever possible, considering patient preferences and values and clinician expertise. According to a review of trauma-focused treatment among military samples, approximately 60% to 72% of military patients retained PTSD diagnosis after treatment. One common concern with trauma-focused treatment is dropout and rates of dropout appear to be similar across PE, CPT and trauma-focused CBT.[1]
Patients need a more comprehensive type of treatment with better outcomes. Talk therapy can appeal to our sense of reasoning and language, but it does not speak to the deeper parts of the brain that experience and store the memories of trauma.
Neurofeedback is a promising alternative approach to ameliorate PTSD symptoms without unnecessary distress. Neurofeedback can modulate brain activity via real-time monitoring and feedback of EEG or fMRI signals, which are used to self-regulate brain functions. Repeatedly induced PTSD-related brain activity during feedback session may change its frequency of spontaneous appearance after feedback session.[2]
A pilot study in 2016 represents a "proof-of-concept" pilot for the use of neurofeedback with multiply traumatized individuals with treatment-resistant PTSD. Participants completed 40 sessions of neurofeedback training two times per week. The study found that neurofeedback significantly reduced PTSD symptoms and preceded gains in affect regulation.[3]
One limitation of current research is that the number of people involved in each study has been relatively small. This is unsurprising, as it is challenging to deliver neurofeedback to large groups of people given the time, space, trained staff, and specialty equipment needed for treatment. Future studies that are larger and better-designed will provide us with more insight into the benefits of neurofeedback.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224348/
[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650780/#:~:text=Neurofeedback%20is%20a%20promising%20alternative,to%20self%2Dregulate%20brain%20functions
[3]https://www.researchgate.net/publication/291328520_A_Pilot_Study_of_Neurofeedback_for_Chronic_PTSD
Implementation
TLP is currently implementing each of the four solutions mentioned in this document with the limited resources gained by donations and self-funding. Thankfully, as we grow, our infrastructure will grow with us; allowing us to bring veterans up through our ranks and provide organic promotion from within. Currently, veterans who have completed EAT, have remained part of the TLP family as volunteers, assistant instructors, and generally provide support for new visitors.
Local Integration
TLP has had community success with multiple TV news stories in addition to local business leaders that show support to TLP’s activities. Each time a story has run on the TLP there is an influx of veterans reaching out for help but due to our size and resources we must turn some away. The Las Vegas VA has reached out and have asked TLP to assist with PTSD affected veterans into the EAT program. At this point, we are at capacity, however, we are still discussing options to work closely with the VA to service additional veterans in the near future. Currently, most of our incoming veterans are referred to us from 22 Warriors, a regional non-profit organization and MVP (Merging Vets and Players), a national non-profit organization. We also take a limited number of word-of-mouth referrals.
Needs Identification
TLP has been in operation for almost two years, and programs are impactful. Despite having infrastructure and systems for our solutions, we have a present and urgent need to scale up and serve our ever-growing waitlist. Organizations such as the Las Vegas VA, 22 Warriors, MVP, and other word-of-mouth referrals reach out to us daily, actively looking for help. The grant from Project Daybreak would allow TLP to scale up our operations to allow us to fulfill these requests and allow us to offer our unique solutions to more veterans.
The grant would allow us to increase our scale in the following ways:
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Equine Assisted Therapy (EAT)
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Existing facility improvements (barn, trails, stalls)
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Add stalls, tack, outdoor lighting
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Add staff, trainers, horses
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Native American Sweat Lodge
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Ability to pay for/host more sweats
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Build Pauite-guided lodge on ranch property, more sweats
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VA Claim Medical Exam Support
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Add experienced administrative staff (VA experience, etc…)
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Add volunteer capacity and outreach
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BrainPaint
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Add technicians and lease more equipment
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Existing facility improvements (offices)
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Host studies, whitepapers on neurofeedback efficacy
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Any additions from the above list or additional capital allows us to increase the number of veterans we are able to serve, to increase the recreational capacity of the ranch to accommodate more veterans, and to bolster community outreach. Through our current community outreach, we not only receive veteran attendance, but veteran volunteers, civilian volunteers, and corporate interest. We understand the value the Ranch as a whole provides, and want to maintain it’s sanctity of community, acceptance, and peace, regardless of growth.
Some future plans include barrack-type group lodging, day room (people barn), and increased recreational amenities. We believe this ranch-based holistic setting provides an ideal opportunity for the veterans to take their time, heal, grow, and keep coming back. We believe there is power when these veterans Come to Heal but Stay to Help.
Team Description
TLP is comprised of many community volunteers and a strong backbone of administrative support. Without the hard work and determination of these dedicated people, we would not be the asset we are to our community.
JP Hoffman – Executive Director/Founder. Service-connected disabled veteran, (resident)
professional horse trainer and master farrier.
Laura Perry – Executive Director Co/Founder. Financial, operational, administrative oversight.
Sabrina Funk – Ranch Manager. Oversight and coordination for access and visitors.
Brianna Blanche – Barn Manager. Oversight, care, coordination for horses.
Jay Schroeder – Former Raiders QB and Superbowl Champion. Fundraising/Public Relations.
Bill Emmell – Service-connected disabled veteran. BrainPaint Administrator & Technician.
Mark Minarik – Pauite Liaison & Sweat Director.
Medical Advisors/Advocates
Dr. Don Posson of the Las Vegas Neurofeedback Clinic and Healthy Brain Resort
Colonel (Retired)/Dr. Jeff Brookman current Las Vegas VA medical doctor and Retired USMC (Medical and Military Advisor)
Military Advisors/Advocates
Deputy Commanding General (Retired) Paul Vallely, Pacific Command, Army
Colonel (Retired) Thomas Williams, Army
Sergeant Major Brad Kasal, USMC