The VA in Florida has begun offering telehealth programs in dance, visual art, and music. The programs link therapists with veterans in their homes.
Without leaving the comfort of his Ocala, Fla. apartment, Joshua Lawhorn, 28, is getting help with his memory problems by learning to play the guitar.
Lawhorn, an active-duty solider, is recovering from post-traumatic stress and traumatic brain injury after a couple of tours in Afghanistan. He is one of hundreds of people enrolled in the Telehealth Creative Arts Therapy program offered by the Malcom Randall VA Medical Center in Gainesville.
Music therapist Diane Garrison Langston connects with Lawhorn for 50-minute sessions that include more than learning new guitar chords. Langston sits in a ground-floor music therapy room at the massive VA complex, while Lawhorn is more than an hour away in his living room.
They chat briefly. Lawhorn tells Langston that he cut his finger while cooking, so he hasn't practiced playing guitar much.
"There is no requirement for how much he's practiced," Langston said. "This is not music lessons. It is music therapy. It's not supposed to be a stressful thing."
Lawhorn confessed that he would probably stop therapy if it "became a chore" or if he had to drive to Gainesville for the sessions.
Langston said that learning to play the guitar is a good coping skill that helps patients focus.
"Not only is it great for finding gross motor movement because you have to strum," Langston said, "it's positive cognitive processing because they're learning a new language."
Nationwide, the VA provides Telehealth services to more than 700,000 patients a year in more than 40 different programs. They include addiction services, women's healthcare, and pain management.
But the Gainesville VA is the first to meld Telehealth technology with Creative Arts Therapy such as music, movement, and visual arts.
"There are some indicators that different engagements in arts can lower your blood pressure and can be good for your heart rate," said Dr. Chuck Levy, Chief of the Physical Medicine and Rehabilitation Service at the North Florida/South Georgia Veterans Health System.
Levy, who oversees the Gainesville Creative Arts Therapy program, has pushed it forward saying veterans can't wait for all the research evidence.
"I would say that the body of evidence is thinner than it is for other practices," he said, "but we need to be doing things now, so off we go."
The Gainesville VA has a five-year grant to mentor other VA medical centers that want to develop Creative Arts Telehealth programs. The Telehealth Creative Arts Therapy program is planning to expand to 10 locations including Fort Hood, Tex.; Camp Pendleton, Cal.; and Camp Lejeune, N.C.
It's also working with the National Endowment for the Arts' Creative Forces program.
Sara Kass is a retired Navy physician who saw first-hand the value of creative arts therapy in treating service members at the Walter Reed National Medical Center National Intrepid Center of Excellence .
"So often, what we need to do in helping patients with post-traumatic stress and traumatic brain injury is understanding their story from their perspective," Kass said. "And the arts give us an opportunity to allow them to tell their story in ways that are different than traditional talk therapy."
Traditional therapy didn't help VA patient Darlinda Reaves, a 51-year-old Navy veteran and cancer survivor. She much prefers to do visual art therapy from her home in Jacksonville, more than a two-hour drive away from Gainsville.
"I find it more relaxing," Reaves said. "I'm really able to express myself more and really tell what's bothering me and what I'm going through without having to get that feeling of being in a hospital or doctor's office where if you say the wrong thing you're going to get judged as 'Oh my gosh, she's severely depressed we need to give her some drugs.'"
Reaves said she didn't draw or paint before signing up with Gainesville art therapist Heather Spooner. But the veteran found power in communicating her feelings through sketches.
Spooner said patients don't need to have art experience to participate in the program. If they're feeling anxious about putting pencil to paper, she'll use a simple exercise. One technique is to ask them to pick a color and create a scribble to show how big their problem is.
"So much of art therapy is about metaphor," Spooner said.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting and the Bob Woodruff Foundation.