Staff Sgt. Anthony Mannino Jr. has overcome a number of setbacks, pushing through recovery of traumatic brain injury and training to finish as a medal-winning athlete at the 2016 Warrior Games in West Point, New York. The U.S. Marine Corps reservist credits the National Intrepid Center of Excellence (NICoE) and its innovative outpatient programs for his ability to focus, work through triggers and compete.

Mannino joined more than 200 service members competing at the 2016 Warrior Games in June. He competed in five events including wheelchair basketball, track and field, shooting and cycling and came home with three silver medals in wheelchair basketball, shot put and discus.

“Some days were worse than others,” said Mannino. “But that’s what these therapies are for – to really try to keep your memory up and stay focused on whatever the task is. It really let me be more open to coaching and not just be angry all the time. I don’t think I would have been able to do all those things without NICoE’s help.”

NICoE, a directorate within the Walter Reed National Military Medical Center and the Military Health System’s Pathway of Care, focuses on research, education and care for traumatic brain injuries. Its outpatient program begins with an intensive four-week course in which patients work with credentialed therapists in group and individual therapies.

Before entering NICoE’s program in November, Mannino tried various medications and therapies after being exposed to blasts in Iraq in 2007 and 2008, and being hit by a truck in 2013. He found them to be less than successful. He didn’t expect NICoE to be any different.

“I figured [the program] would just be different doctors looking at the same stuff and saying, ‘Oh okay, this is what you got. You have to take x, y, z medications.’ But I was just blown away,” he said. “They really took care of us and they really explain things in detail. I did a six-month program [elsewhere] that didn’t get as much accomplished as NICoE did.”

Since January, he has continued with weekly music and art therapy sessions – a favorite form of therapy for Mannino.

Creating art, such as paintings or music, and talking through the project with a therapist is a proven method of stimulating various parts of the brain, opening communication channels and improving health conditions for various medical, psychological and neurological health issues.

“We have seen a breakdown of the speech area of the brain which is why we believe they [the patients] sometimes have trouble expressing themselves verbally,” said NICoE art therapist Melissa Walker. “But when they make the art and get to talk about it with a therapist that starts to open up those pathways again. We are seeing evidence of greater optimization or reactivation of the right hemisphere of the brain where all the sensory mechanisms are.”

This form of therapy has been around for some time, and NICoE’s model is now being replicated at other major installations after being well received among service members. The center keeps track of the success of therapies through discharge summaries and self reports, according to Jessica Gada, Mannino’s art therapist at NICoE. Feedback from more than 200 service members in two years showed art therapy to be in the top five therapies out of 40 the patients are exposed to at NICoE.

While Marines aren’t known for artistic abilities, Mannino teased, he encourages his fellow service members to try everything and be open to different types of therapies.

“I’ve got a lot of buddies still that are in a dark place in a bad way,” said Mannino. “Sometimes you don’t realize you have TBI or you don’t understand why you can’t do things like you used to and gets you down. A lot of guys facing depression don’t know who to talk to, but there are guys with legit issues out there and this helps.”