Coming Home Project Independent Program Evaluation Cassandra Vieten, PhD
Peter Lewis, PsyD
This program evaluation assesses effects of participation in Coming Home Project retreats in 175 participants from four CHP retreats in 2010.
Participants completed surveys 2-4 weeks prior to attending the retreats, the day of arrival, the day of departure, and 4-8 weeks following the retreats.
Participants reported a high level of satisfaction with the retreats, evaluating the locations, the staffing, and the activities very positively.
From 2-4 weeks prior to the retreat to 4-8 weeks following the retreat, participants reported statistically significant improvements in every intended outcome, including greater self-acceptance, connection to others, sense of meaning and purpose, healthy expression of emotions, skills for self-regulation, and ability to take action to improve their lives.
In addition, from the day participants arrived at the retreat to the day they left, participants reported substantially significant reductions in stress, exhaustion, feeling burned out, anxiety, isolation, hopelessness, and feeling emotionally numb. They reported significant increases in happiness, relaxation, ability to care for themselves and calm themselves after a stressful day, and feeling more energized, connected, supported, and hopeful. These improvements observed over the course of the retreat remained statistically significantly improved at the 4-8 week follow-up – in other words, benefits of the retreat were sustained.
This report indicates that Coming Home Project retreats are successfully meeting their intended goals: to offer returning veterans and their family members a space for healing and renewal, skills for reducing stress and coping with life, a sense of meaning, purpose, and hope, and empowering them to feel like they can take action in their lives.
The Coming Home Project is a non-profit 501(c)(3) organization committed to alleviating the unseen injuries of war faced by Iraq and Afghanistan veterans, service members, and their families. We promote wellbeing across the deployment cycle and provide support for successful reintegration into civilian life. Our programs address the whole person with an integrated, evidence-based, bio-psycho-social-spiritual approach. We help veterans and their families rebuild the connectivity of body, mind, heart and soul, that can be unraveled by combat-related trauma, renew relationships with loved ones, and create vital new peer support networks. The Coming Home Project’s residential retreats create a safe place of belonging and community where participants share stories and experiences, learn critical resilience skills, enjoy expressive arts and outdoor recreation, and participate in secular ritual that recognizes, honors and helps integrate experiences. Coming Home retreats are not psychotherapy, but they are therapeutic educational, recreational and community-building workshops. They are peer-support driven and facilitated by experienced licensed psychotherapists and trained older veterans and chaplains. We welcome veterans, Guard, Reserve and Active Duty as well as their immediate and extended family members, including children. Our retreats build a community where veterans come together to reintegrate with their families, peers and communities – and within themselves, as they connect with services and resources in their region. Initiated in 2006, Coming Home programs are free and confidential.
Description of Evaluation Process Coming Home Project participants are asked to complete five brief surveys in addition to their initial registration form. First, the Pre-Retreat Survey is administered within two weeks of the start of the retreat, and includes items related to demographics, military history, motivations for participating, and items reflecting outcomes that developers of the Coming Home Project Retreats have observed in previous participants. The Entry Survey is completed when the participant arrives at the retreat, and includes items related to feelings, thoughts, and stress levels over the previous one to two weeks. The Exit Survey contains the same items as the Entry Survey, except participants are asked to respond to items with respect to how they feel upon the close of the retreat. The Program Evaluation asks participants to rate specific elements of the retreat. Both of these are collected on the last day of the retreat. The Post-Retreat Survey is completed approximately one-month following the retreat.
Demographics of Participants There were 175 adults attending four retreats. Demographics are below:
41.7% were male and 58.3% were female.
5.1% were between the ages of 18-24, 20% were 25-30, 21.7% were 31-35, 13.7% were 36-40, 17.7% were 41-45, 7.4% were 46-50, 6.3% were 51-55, 3.4% were 56-60, and 4.6% were over the age of 61.
34.4% were White
11.8% were Black/African American
1.4% were Native American.
17% were Latino
8.5% were Asian/Pacific Islander
9% were of mixed racial background
53.7% were veterans or on active reserve, and 46.3% were not.
35.2% were on active reserve and 64.8% were veterans.
67% were members of active duty, 13.6% were on Reserve, and 19.3% were in the National Guard.
56% were in the Army, 16% were in the Navy, 13% were in the Air Force, and 17% were in the marines.
8.6% were not deployed, 50.5% were deployed once, 23.7% deployed twice, 7.5% were deployed three times, 5.4% were deployed four times, 2.2% were deployed five times, 2.2% were also deployed six times. Nobody chose option 8 and therefore none of the people in the dataset were deployed seven or more times.
MARITAL STATUS & Children
31.6% were married, 1.4% were separated, 5.7% were divorced, 0% were widowed, 4.7% were single and 1.9% had a domestic partnership.
78.3% had children and 21.7% had no children.
20.3% had one child, 35.1% had two children, 29.7% had three children, 8.1% had four children, 2.7% had 5 children, 2.7% also had six children, and 1.4% had nine children.
11.7% made under $20k per year, 24.5% made $20k-$40k, 23.4% made $40k-$60k, 19.1% made $60k-$80k, 8.5% made $80k-$100k, and 12.8% made over $100k per year.
TIMES OF USE FOR REINTEGRATION
46.8% of people had not used VA or DOD services in the month prior to the retreat, 19.1% have used once, 10.6% have used twice, 4.3% have used three times, 7.4% have used four times, 1.1% have used five times, 1.1% have used six times, and 9.6% have used seven or more times.
Motivations and Feelings About Attending the Retreat Main Reason for Attending the Retreat
19.1% of participants cited being “curious about the Coming Home Project” as their primary reason for attending the retreat
16.2% cited “interest, self-referral”
19.7% were referred by a friend, peer or family member
21.4% were referred by a previous attendee
12.1% were referred from professional or community source
11.6% from other sources
What did Participants Most Hope to Gain from the Retreat?
12.6% cited “Obtaining peace of mind or a sense of control”
14.9% cited “Finding meaning in my past experiences and in the future”
1.7% cited “Developing friendships with individuals sharing similar experiences”
10.9% cited “Reconnecting with myself, friends, spouse, children, or other family members”
36.2% cited “Learning practical skills that will help me deal with my emotions (for example: mindfulness, anger management, interpersonal communication skills, or relaxation skills)”
23.6% cited “other”
Feelings Prior to Attending the Retreat A wide range of feelings were reported – a representative sample is below:
Nervous, Excited, Anxious, Hopeful
Excited, I had good memories from previous retreats.
I am very excited to be here.
I am curious about the conference and how I can help others.
Hope, fear, nervous.
I'm neutral right now, trying to feel everyone out.
Nervous and afraid.
Anxious to neutral bordering on annoyed by all of the requests for information.
I am excited about the experience and I am thrilled to have my husband to come along so that he can understand what we go through.
I'm a little curious because it sounds pretty structured, to be in my opinion a bonding and healing retreat. I wonder if we'll be asked to mainly confront our fears, or be helped to find the happiness of life today. But overall i'm excited.
Pre- and Post-Retreat Surveys (2-4 weeks before and 1-2 months after) Items on the Pre- and Post-Retreat Surveys were answered on a scale of 1-5, with being “Disagree” and 5 being “Agree.” All 32 items on the Pre- and Post-Retreat surveys showed substantially significant improvements, with the exception of two.
Table 1 – Changes in Items from 2-4 weeks Pre-Retreat to 4-8 Weeks Post-Retreat
1. I feel I have purpose in life.
2. I feel that I accept myself as I am.
3. I am able to talk about my experiences with others.
4. I find meaning in the difficulties I have experienced.
5. I accept my life experiences.
6. I understand the areas that I need to work on myself.
7. I feel overwhelmed by the power of my emotions.
8. I feel like I can shape the course of my life.
9. I feel connected to my family members.
10. I feel connected to my peers.
11. I feel like I know myself.
12. I feel supported by my family.
13. I feel supported by my community.
14. I feel a sense of hope.
15. I am open to seeking assistance with reintegration challenges.
16. I feel able to learn from my experiences.
17. I am able to see benefit even in very difficult experiences that I’ve had.
18. I have the ability to change things in my life.
19. I can recognize and respond to beauty around me.
20. I express my powerful emotions, such as anger and sadness, in healthy and constructive ways.
21. I feel distant or cut off from other people.
22. I am able to have loving feelings for those I feel close to.
23. I am able to accept help from others.
24. No one understands what I’ve been through.
25. I feel that people really care about me.
26. I feel a sense of inner peace or harmony.
27. When I get upset, I have tools I can use to calm myself down.
28. I feel that my life is meaningful.
29. I express my anger and sadness in unhealthy ways.
30. Many strong emotions and reactions I experience are normal considering what I have been through.
31. It is okay to look to others for support.
32. I have the inner skills I need to meet the emotional challenges in my life.
Entry and Exit Surveys Items on the Entry Survey (first day of retreat) and Exit Survey (last day of the retreat) were answered on a 1-5 scale, with 1 being “Disagree” and 5 being “Agree.” Substantial statistically significant positive changes were observed in participants from time they began the retreat to the time they ended it (see Table 1).
In other words, participants experienced substantial statistically significant reductions in stress, exhaustion, feeling burned out, anxiety, isolation, hopelessness, and numbness, and significant increases in happiness, relaxation, energy, feeling connected, feeling supported, hopeful, and able to calm themselves.
Table 2 – Changes in Items from First Day of Retreat to Last Day of Retreat
Trajectories of Change We also examined changes in the 15 items on the Entry and Exit Surveys and whether those changes were retained at the 4-8 week follow-up. In those who responded to the 4-8 week follow-up survey, statistically significant improvements were sustained, with the exception of “Able to Care for Self” and “Hopelessness.” Below we summarize this finding separately for positively worded items and negatively worded items. Again, items were responded to on a five-point scale with 1 being “Disagree” and 5 being “Agree.”
Table 3 – Changes in Positively Worded Items from First Day of Retreat to Last Day of Retreat and 4-8 Weeks Later
Positively Worded Items
First Day of Retreat
Last Day of Retreat
One Month Later
Able to Calm Self
Able to Care for Self
Figure 1 – Trajectories of Change from First Day of Retreat to Last Day of Retreat to 4-8 Weeks Later for Positively Worded Items
Table 4 – Changes in Negatively Worded Items from First Day of Retreat to Last Day of Retreat and 4-8 Weeks Later (note: means for first day and last day may differ from those above because only participants who completed the 4-8 week follow-up are included below).
Negatively Worded Items
First Day of Retreat
Last Day of Retreat
One Month Later
Figure 2 – Trajectories of Change from First Day of Retreat to Last Day of Retreat to 4-8 Weeks Later for Negatively Worded Items
Program Evaluation On the last day of the retreat, participants rated the following items on a scale of 1-5, with 1 being “Disagree” and 5 being “Agree.”
Table 5 – Mean Ratings of Program Evaluation Items on Last Day of Retreat
1. I found meaning in the suffering I have experienced.
2. I felt more hopeful about the future.
3. I felt a renewed sense of purpose in my life.
4. I felt I had control over my life and the power to change certain things.
5. I felt a sense of relief.
6. I felt that I could better manage my emotions.
7. I felt more aware of the things I need to work on in my life.
8. I would be open to getting help with reintegration challenges.
9. I felt more calm and whole.
10. I felt my physical pain ease.
11. It felt good to let go of the feelings I had bottled up inside.
12. I learned new and helpful ways to care for my physical and emotional well-being.
13. I feel less isolated now.
14. I felt supported by my peers.
15. I learned from others' experience.
16. I felt a sense of belonging, like being part of a community.
17. I felt accepted for who I am.
18. I realized I am not alone in my struggles.
19. It was helpful to be with others who were coping with the same issues as me.
20. I felt more comfortable at this retreat than I have for a long time.
21. I learned that there are others I can trust.
22. I learned to trust myself more.
23. I felt safe with this group.
24. I felt gratitude for community support.
25. I learned about programs available to service members and their families and would consider seeking assistance.
In other words, with the exception of easing physical pain, all respondents evidenced strong agreement with each of the items presented.
Finally, responses to open-ended items asking participants to note they wanted to say about their retreat experiences were as follows:
learning to be able to calm myself so I don't explode- I hope I can stay dedicated to this.
sharing free time with brothers and sisters, meditation, meetings with facilitators. These all brought me out of my cave. I started enjoying all activities.
the small focus groups helped the most in reassuring me that I am not alone
small group meetings were important to me because we could all talk freely and help one another on the spot.
listening to stories of other people, its important to know what are the signs and how do they feel, and the resources to look for getting help
I feel like the small group time was an important time because it gave everyone a chance to say how they feel and what is on their mind
the small group discussion allowed me to freely discuss unresolved issues. Meditation and qigong provided me with new stress management techniques. It was important to discover I was not alone and the only person feeling as I do.
The rope activity allowed my husband and I to work together as a team. He trusted my ability to get us to the next level.
high rope climb because it promoted team work between my wife and I because in order to succeed we had to work together
groups and group activities. It helped me to feel better about myself and situations to feel less alone and that i was important too.
I felt that the opening and closing meditations we did in large/small groups was most beneficial as well as the small group sharing sessions.
talking with other participants! realizing you are not alone with your emotions
they were all excellent. Evening exercises were calming and interaction helpful. I believe the single groups were helpful, I learned about other experiences by listening and caring
talking with others
child care- allowed me to focus and participate small groups- enabled me to encourage other spouses to share that we all have "issues" even though they may be different
talking with other participants because everybody was given a chance to share their stories which is a good learning process
talking with other participants, become connected and realize that I am okay, someone is just like me. Talking with facilitators helped me understand more.
Group therapy because it was possible to open my heart
small group felt like my own family at retreat, meditation was a relaxing way to start day in community, ropes built confidence and comraderie, star gazing was something I never had done and was touched that members of the local community came to share their passion with people they didn't know
free time- reconnect with wife (I-Do) Group- talk to those who share issues Group meals- talk to families, loved ones
talking with and listening to other participants
small groups- I needed the support and to vent from other spouses (gonna miss that!)
I was able to spend more time with my kids doing outdoor activities (fishing)
small groups, stargazing, and community events
small groups and family "together" activities
meditation made me feel at peace. qigong made me physically feel better
community things- small groups
camp fire, astronomy, high/low rope- all these events showed me the simple joys in life that allow us to connect and balancing everything
group sharing- an opportunity to share with others having similar experiences
talking with other participants because you get a chance to express yourself
Qigong helped me relax and meditation helped me deal with stress. I bonded with others and made new friends.
Break out sessions- got closer to the other vets and could relate to their struggles. High ropes course- never had a chance before to work with my wife in that way. It was very bonding.
Each and every activity was great and important. Each brought a positive turn in our lives. The fair was great to get information personally and to share with my home. Telescope viewing was a great time with my daughter and I, and connecting on school issues. Free time was the best as I mainly used to spend with my husband. All thanks to child. As we don't have such option at home. Not to mention we felt comfortable leaving the baby with them. So it was a stress free "us" time. And we LOVED it!
the group sessions (both community and small sessions) helped me release a big demon from Iraq. I felt supported, and trusted the peers within those groups
Qigong, family time, arts/ crafts with kids, alone time when kids are with child care team
qigong, meditation (relaxing and stress relief), group sessions (try to connect with others, relieving), high adventures (challenging and exciting), swimming (exercise relief), walking, stargazing (relaxing and very informative)
the small group meetings
this retreat has helped me to become hopeful and know I can be better as a father/ husband
I would like to thank everyone invloved. I am truly grateful. For as I said before I now have hope.
more information on the daily structure. single parent families need to know what expect and time to explain the limitation difference to the child.
The staff was outstanding!!
Logistic a wonderful job, everything in the retreat was fantastic. This was a wonderful experience. The place is beautiful, the nature and beauty transport you in your mind to a peaceful place where we feel very relax, peaceful, and give you the time and opportunity to revise your life, your goals on life and the purpose of your life. Thank you for all you do.
The staff is superb. Everything ran so smoothly and every one of needs were met. They far exceeded my expectations. I would recommend this retreat to every OEF/OIF vet/serviceman. This is the type of community building experience we need. This has changed my life!!
I'm happy to have been able to partake in this retreat with my spouse, made new friends, and met a wonderful staff.
I had a wonderful time, even without my TV
This retreat is important to our family so needed and we wish and hope this continues! This is the type of community support needed
Although a little apprehensive at first, this has been one of the best experiences I've had since returning in 2005 and retiring in 2007. Keep up the great work you do
the most memorable experience of my life. So much support from such wonderful people. Plus help- amazing!
The activities for the adults were challenging. I like the children.
TV in room because room felt like I was in Iraq again. Needed roommate or a radio in room. Like the retreat and appreciated all the staff's hard work
I am so very glad I came to this retreat. It has truly been a life changing experience. I will tell everyone I know who might benefit about Coming Home Project
It was awesome, I highly recommend to all vets. Great people, great place, great memories
I loved it! We are so grateful for this. May God Bless you all for everything
I like to volunteer for the next available retreat. Thanks for a great weekend, this really helped me and my family
the CHP outdid themselves again! a wonderful, reenergizing experience. Thank you!
Joe and the entire Coming Home Project went above and beyond. It was awesome.
The Coming Home Project is a great "boot camp" for handling the rest of my life
I think it was helpful and very beneficial to our family
this was a great way to "de-stress" and socialize with others that have experienced the same issues
great location. there was no way that you couldn't just slow down and relax. I hope they do this again next year!
The retreat is great! Since we have been back home as a family, we have been to other retreats. Nothing like this. This by far the best one. Will recommend if space available for new ones. Would love to come. Everything so well thought out.
the staff overall was wonderful. I was a very different person when I got here. I am more relaxed
it was great that people cared enough to donate money and time to this cause and hopefully there will be more opportunities for other retreats in the future
When asked to comment on anything the retreat could have done differently to improve, representative responses included:
The change was already made- explaining to active military that stay focused and don't recognize issues to keep their judgmental comments to themselves. Thank you
there is no way that it could have been better. All of the PTSD treatments helped very little. However this helped a lot and now I have hope!
another day or two
not too much, the program was pretty solid.
I will have a sitting chart for one of the meals, I'll make sure everybody seat in a different spot to give them the opportunity to meet each other. I'll do a little more bottle body interaction at the beginning of the retreat to make sure people feel comfortable in their group.
nothing. everything was great
I am extremely happy and impressed with the program. I would not change anything.
This was my first experience and I wouldn't change the things we work at, but add more high adventure activities like an obstacle course.
That groups be with people who are having issues with PTSD when others said there was nothing wrong we (I) felt like why are you here? Was harder to share.
My initial thought when I walked into my room was a immediate flashback to Iraq and living conditions there, however much nicer here it still reminded me of that but later it grew on me. It might be helpful to alert participants to that so they are not in shock.
Nothing, I did not know what to expect but I felt at home. I wish some other people were here from 3ID but were not
time for exit
1. put the two blocks of free time together to allow more continuous time to do stuff- either put it all after lunch with a session following, or put the session after lunch with free time following 2. include more instruction and education
More activities prepared for like fishing, longer pool hours
nothing, very good
I enjoy doing yoga if that could be worked in. But qigong and meditation were great too.
add couples group time to discuss those problems. Reconnecting to spouse.
couples session would be great
please let me know how can I help
at some point combining the male and female vets
More time for small group break outs. Spouses with vet groups for a brief time would be good.
the organization and retreat helped me to reach my heart again. the content was what i needed. i thought initially maybe more events for those that are by themselves, but that subsided at the end.
i would like to see time for at least one opportunity for small group break outs with two small groups together in family members with veterans small group and one small group by service in an army, all marine, etc.
I would have some communication workshops
Absolutely nothing! it was perfect
maybe just one more small group session.
The retreat to me is great changing minimal to nothing at all. My only suggestion is limited those that have attended 3 or more times to a minimum as they tend to taint other's experience. Just a thought.
I like the format as it is
good choices for young kids
add some group walking (during the day) to see things such as the pond, birds, cows, observatory, etc
Four to Eight-Week Follow-Up Reflections by Participants When asked four to eight weeks later what stayed with them from the retreat they attended, representative responses included:
I was not the only person feeling the way I did.
So much to be able to put into words. But had a sense of belonging meeting with other wives that go and experience the same feelings, emotions, and rough times as I have. Felt like a lonely loser. Realized we are not losers and we/I am not alone. Not Only that I am not alone but that there is help. Just a matter of extending my hand. Starting with my friend/my partner/my husband. The ability to open up and let him in. For him to feel the same sense of emotional and understanding from me. Without screaming without hurting each other verbally. We learn it does not matter how long the struggle we have each other. A beautiful family. Living today to the fullest. An eye and heart opener retreat!
Sharing stories with the other guys.
The serene atmosphere which allowed myself to feel comfortable to opening up with my fellow combat vets. The support network from the facilitators touched me deeply and I am forever grateful for everything that the organization does.
The sense of Community.
The beauty of the place I stayed at. Being able to fish and teach children to fish.
the camaraderie, I loved meeting with the other vets and their families, lets us know that we are not the only ones with the same exact issues. The team building rope climb was awesome! Diane and I still speak about that to others!
The sisterhood of all the other women Veterans moved me, and reassured my strength in being a woman Veteran and not just one of the guys. My identity as a woman, as a Veteran, plays a major role in my life, and I’ll never compromise who I am.
The ability to accept my husband for who he is and work on making myself happier instead of everyone else. Spending FUN time with my family
Knowing that I am going in the right direction in learning to become less aggressive and less yelling at my kids. Helping them understand the new me .I still do not like myself as to whom I became after combat.
Coping skills I learned to help me understand my wife and kids.
The friendships that I made with others in my same situation as well as ways to be able to talk about and deal with stress
Conclusions This analysis indicates that participation in Coming Home Project retreats was a very positive experience for participants. Positive changes in mood, stress levels, confidence in ability to care for themselves, self-awareness, willingness to access help, feeling less isolated and more able to connect with others were observed from prior to the retreat to after attending the retreat. A significant strength of these findings is that every item changed in the expected direction, and most evidenced substantially statistically significant improvements. This pattern of findings indicates an overarching positive effect of attendance at the retreat.
One limitation of this analysis is that 17% who participated in the retreats did not complete the follow-up measures. It is possible that those people were having different experiences than those who did respond (better or worse) after the retreat, and had they answered the questions it could have affected the results. People who did not respond to the follow-up survey did not differ from those who did on demographics such as income, number of deployments, education or age. Future retreats should emphasize the importance of completing the follow-up measures, and CHP may want to consider a financial or gift incentive for completion of all measures.
Future work might include a longer term follow-up, research on mechanisms of action (in other words, what aspects of the retreats account for the improvements observed), and comparisons with a wait-list or other control group.
Evaluator Contact Information:
Cassandra Vieten, PhD
76 Cypress Place
Sausalito, CA 94965
Coming Home Project – Independent Evaluation 2-25-2011