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FORWARD OPERATING BASE HADRIAN, Afghanistan — The face of combat therapy at outlying U.S. bases in Afghanistan is changing.

Capt. Annie Heirendt, a licensed social worker with the Army’s 254th Medical Detachment, a Combat Operational and Stress Control unit, and others are increasingly conducting sessions via video link from a central location.

“The idea is, there’s not enough providers to go around, so if there is a computer that can connect back to a provider, you’re allowing that consistency, that continuity of care and support,” she said.

The drawdown of troops in Afghanistan also has led to fewer rotations of therapists to outlying forward operating bases, where in many cases troops are preparing either to close or turn over the bases to Afghan control. Therapists have been pulled back to larger bases, spurring a push by combat stress control units to get the video conference systems up and running at more FOBs.

Heirendt traveled to Forward Operating Base Hadrian in Uruzgan province recently to set up a Tele-Behavioral Health system.

“We will go on battlefield circulations, for example, once a month, but that’s not consistent enough support,” Heirendt said. “With this system, if I do an intake with somebody, I can schedule a follow-up in a week through TBH. It’s basically 24/7 behavioral support.”

There are too few behavioral health providers in the military, Heirendt said, so teleconferencing is critical to meeting soldiers’ needs. For example, she is the only behavioral health provider for U.S. troops in all of Uruzgan province.

“Basically, there are not enough of us. I think it’s second best,” she said of the tele-counseling program. “Some of the FOBs are really far out there, and it’s still a really clear picture, with little delay,” Heirendt said of the tele-therapy system. “Whether or not it’s utilized to it’s maximum extent, I’m not sure that actually happens, but I think it’s a stress reliever to know that if somebody is having an issue, there is an avenue, a means available for them to be able to connect.”

Sgt. Eric Thompson, a medic at FOB Hadrian, said, although only a few soldiers a month use the system, he considers it a necessity. “I’ve heard soldiers say, ‘I just needed someone else’s opinion outside of my own,’” said Thompson, who is with the 56th Infantry Brigade Combat Team.

“Just in case something does happen, and our soldier does need that, that’s something that’s easy,” Thompson said. “It’s just like setting up a normal computer, and having normal access. Why not have it everywhere? It’s definitely a benefit.”

In some cases, soldiers have been unaware that tele-counseling was an option.

Capt. David Awanda, head of the 254th Medical Detachment COSC unit, said making people aware is key.

“The system is out there, and we just keep on pounding the pavement, making sure we have this aggressive campaign to push it out there, making sure people know the capabilities and know how to use it,” Awanda said from FOB Tarin Kowt, the headquarters base for Combined Team Uruzgan in Uruzgan province.

“And the areas without systems, we try to get the commanders to understand what the system does, and the capabilities that the system will provide to the commander and his or her troops. So that they buy into it,” he said.

“A lot of the ones we don’t see too much in terms of usage [are] strictly infantry guys. They tell us they have their own coping mechanisms, but we do go out there and talk to them anyways,” Awanda said.

Heirendt will continue traveling to outlying FOBs in support of the digital therapy mission.

“The warriors deserve support, so any way you can provide it is a good way,” she said.

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