Project Healing Waters Fly Fishing Inc. began in 2005 at Walter Reed Army Medical Center serving wounded military service members returning from combat in Iraq and Afghanistan. Since Ed Nicholson, a retired U.S. Navy captain, began teaching these wounded warriors how to cast, Project Healing Waters has expanded nationwide, establishing its fast-growing program in Department of Defense hospitals, Warrior Transition Units, and Department of Veterans Affairs medical centers and clinics.

In a few years, six staff and over 2,500 volunteers were serving up to 6,000 disabled veterans. And just since 2012, Project Healing Waters has served over 65,000 veterans, including a growing number of female veterans, suffering from physical injuries and post-traumatic stress disorder. The organization also lends focus on supporting veteran amputees, many of whom have learned to tie flies with one arm.

Fly tying and rod building also help vets recover motor skills and the camaraderie and the fishing help with PTSD, anxiety and depression — all vital to reducing the veteran suicide rate. An army of volunteers helps these healing veterans, combining fishing with stream rehabilitation, mangrove removal and trash pickup — all needed to preserve the vitality of fly-fishing streams.

Based on 19 years of anecdotal evidence, current CEO John Langford is confident that fly fishing has been a powerful tool in helping disabled veterans heal from PTSD.

But now, thanks to a partnership with the digital therapeutics company MindStreet, Project Healing Waters may soon be able to provide scientific evidence as to precisely how the organization benefits veterans.

In a recent joint interview, Langford said that there is a lot of storytelling and qualitative information around the healing power of the outdoors, and fly fishing in particular. Project Healing Waters, however, now seeks to add a new focus on collecting quantitative data in the veterans’ mental health space to assess the efficacy of its programs.

Langford says the anecdotal stories are powerful, but in-part, from a business standpoint — seeking grants and other financial support — they are not enough.

For example, to qualify for a grant from the Wounded Warrior Project, you need data to support your application. Without that data, you will not even get an invitation to apply for a grant. That recognition made becoming a data-driven organization a major priority.

According to Board Chair Blain Tomlinson, human capital executive Jerry Bratkovich suggested working with MindStreet to increase the validation of Project Healing Waters’ programs.

And so, working together, MindStreet and Project Healing Waters designed a pilot study, which is now in progress.

Langford calls the collaboration with MindStreet “one of the most significant sea changes” for the organization since its inception, and a deliberate effort to collect data to show that its programs actually work in supporting traumatic growth, building resilience, and reducing isolation that can lead to veteran suicides.

It is impossible, he says, to overstate the significance of the effort.

MindStreet’s Dr. Jesse Wright created the “Good Days Ahead” digital program to help people address mental health conditions. According to Wright, Good Days Ahead grew out of his cognitive behavior therapy (CBT) training; CBT has been shown to work in over 400 randomized controlled trials.

He describes the program — the model for the Project Healing Waters trials — as a pragmatic approach to self-care.

Trial participants interact with a computer program that teaches them some of the basics that therapists use to teach patients. It is based not on psychoanalysis, but rather on how participants cope with trauma, depression and anxiety.

Today, the CBT-based Good Days Ahead program is being used at universities such as Yale, Pennsylvania and Indiana.

Wright, himself a former military psychiatrist and lifelong fly fisherman, says he is thrilled to play a role in helping Project Healing Waters build a quantitative record of what everyone hopes will show its success.

MindStreet CEO Brian Mayhugh says that the objective of the Project Healing Waters study is to scientifically prove that two decades of anecdotal evidence can be demonstrated using scientific analysis. To accomplish this, the study was designed to test whether the nature-based fly-fishing program can be combined with a digital CBT program to help veterans heal, feel and stay better.

To ensure its validity, the study was submitted to an Institutional Review Board for approval. MindStreet is also measuring some critical mental health markers before and after the veterans who opt in to the study participate in what Mayhugh calls a “historic” program.

Volunteers participate in an assessment a week before the weeklong outdoors program. And four weeks after the week of fly fishing, the participants undergo a second assessment — This avoids measuring any euphoric high from the week with friends and others in the outdoor fly-fishing environment, and enables better determinations as to whether the results are sustained over time.

To date, about 200 veterans have participated in the study, and another 30 or so are expected to complete the weeklong program this year; a sample size sufficient to avoid having to recruit outside the Project Healing Waters community. The entire assessments are further done digitally, using a landing page designed specifically for the veterans’ study.

According to Langford, the participation rate has been excellent. The Good Days Ahead program, as modified to suit the veterans, is fast becoming an intake tool that will help Project Healing Waters be better prepared to serve each new fly-fishing veteran.

Mayhugh says that the data collection for this initial-year pilot study should be completed in mid-January — This includes both the pre- and post-program assessments and utilizing the digital therapeutics for program resilience.

After a thorough analysis, ensuring absolute privacy for all participants, MindStreet and Project Healing Waters hope to announce the results in early spring 2025. And as soon as fly-fishing season begins in 2025, the plan is to begin a second round of assessments.

Ultimately, entering a trial is an act of courage, because you never know the outcome ahead of time. However, the MindStreet and Project Healing Waters teams, in addressing the challenges facing America’s heroes returning from the ultimate sacrifice in support of country, are confident that data-driven evidence will support what they’ve always known, and what our veterans are telling us: Embracing the majesty of America’s outdoors and re-establishing community and camaraderie in the process, through the sport and art of fly fishing produces impactful, lasting results — a model replicable the country over.

Duggan Flanakin is a senior policy analyst at the Committee For A Constructive Tomorrow, a nonprofit organization that advocates for free-market solutions to environmental issues. He writes on a variety of public policy issues.